Expanding an innovative Bedside Concierge program
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1 E3 (EFFECTIVENESS, EFFICIENCY, EXCELLENCE IN HEALTHCARE) GRANT CASE STUDY ALL IN FOR GOOD Expanding an innovative Bedside Concierge program Patients get prescriptions delivered bedside, and can consult electronically with a pharmacist before leaving the hospital
2 Bedside Concierge Mountain States Health Alliance Johnson City, TN To increase medication adherence for patients as they transition to home, Mountain States Health Alliance expanded its Bedside Concierge program, which delivers prescriptions to a patient s bedside and connects the patient to a pharmacist via FaceTime. Overview of organization Mountain States Health Alliance is a community-based nonprofit health system with 13 hospitals that serve people in 29 counties in Tennessee, Virginia, Kentucky and North Carolina. Mountain States is also a teaching health system, and provides training and residency opportunities for medical students, as well as training opportunities for nursing and pharmacy students. The program has been so successful that we continue to expand it. It has contributed significantly to cost avoidance; more importantly, it has improved the health and safety of some of our most at-risk patients, and allowed them to stay safely at home. Anthony Hammond Outpatient Pharmacy Director 2
3 Project summary Several years ago, Mountain States Health Alliance determined that many of the patients who were readmitted to hospital had not gotten their prescriptions filled after they were discharged the first time. So it launched its Bedside Concierge program in two of its largest hospitals; funding from the Cardinal Health Foundation allowed Mountain States Health Alliance to expand the program into a third hospital. The Bedside Concierge program is optional; services are provided at no cost to the patient. When patients opt into the Bedside Concierge program, they are assigned a Coordinated Care Guide, a pharmacy technician who works under the supervision of Mountain States Health Alliance pharmacists. The Coordinated Care Guide ensures that patients prescriptions are filled and delivered bedside. (Mountain States Health Alliance accesses pharmaceutical companies patient assistance programs to provide free medications to those patients who cannot afford to pay for them.) The Coordinated Care Guide visits the patient to review discharge instructions with the patient, then uses a tablet to connect the patient to a pharmacist via FaceTime, right from the patient s bed. The pharmacist reviews all prescriptions with the patient, and asks probing questions to ensure that the patient understands why each prescription was prescribed and what it is for. The Coordinated Care Guide ensures that the patient has any additional daily living tools (Nebulizer, walker, blood pressure cuff, etc.) he or she may need before leaving the hospital. The Coordinated Care Guide then visits the patient at home within 48 hours of discharge, using FaceTime again to connect the patient with a Mountain States Health Alliance pharmacist. During this visit, the pharmacist focuses on medication adherence, and determines whether any labs need to be done and makes recommendations to the patient s physician, as necessary. The Coordinated Care Guide provides one final check-in with the patient within 10 days via telephone, using a checklist to follow up on findings from the initial in-home visit. 3
4 Project objectives Ensure patients have all prescriptions prior to discharge, as well as medication education Provide post discharge follow up Reduce hospital readmissions by 35 percent Results (for about 1,500 patients) Reduced hospital readmissions by 40% Estimated readmissions saved: 49 Hospital days saved: 1,012 Dollars saved: $1,876,611 Lives saved: 1 Bedside Concierge services are optional and are provided at no cost to the patient. 4
5 Project continuation The program has been so successful in improving the health and safety of patients as they transition to home, and in decreasing hospital readmissions, that Mountain States Health Alliance has continued to expand it, and ultimately hopes to be able to offer Bedside Concierge services to patients throughout its entire healthcare system. As a pilot program, the organization has recently hired a Clinical Care Coordinator, a licensed practical nurse who visits patients with CHF and COPD in their homes post discharge from one of the organization s smaller hospitals. If the patient has questions about medications, the LPN connects the patient to a pharmacist via tablet. She makes sure the patient has a primary care physician and has scheduled appropriate follow up appointments, and determines whether the patient needs any in-home care. About 72 percent of patients choose to participate in the Bedside Concierge program; for those patients, readmission rates have continued to drop, by more than 50 percent. Mountain States Health Alliance leadership Alan Levine President and CEO Anthony Hammond Outpatient Pharmacy Director 5
6 About the E3 Patient Safety Grant Program Since 2008, through its E3 Patient Safety Grant Program, the Cardinal Health Foundation has invested in hundreds of healthcare organizations across the country. We support a wide array of patient safety work with a focus on accelerating the rate of change with two goals: Improved patient outcomes Reduced healthcare costs Because of the complexities in healthcare and healthcare systems, it takes an average of 17 years for evidence-based practices to be fully implemented into healthcare practices, according to The National Institutes of Health. Within a year or two, some of our grantees are affecting change, eliminating errors and creating lasting improvement. They are reducing readmissions to hospitals, reducing lengths-of-stay and, most importantly, saving lives. For more information, visit cardinalhealth.com/ patientsafetygrants. About the Cardinal Health Foundation The Cardinal Health Foundation supports local, national and international programs that improve healthcare efficiency, effectiveness and excellence and the overall wellness of the communities where the Cardinal Health (NYSE:CAH) nearly 37,000 employees live and work. The Cardinal Health Foundation also offers grants to encourage community service among its employees and works through international agencies to donate much-needed medical supplies and funding to those who need them in times of disaster. Cardinal Health is #AllInForGood. To learn more, visit cardinalhealth.com/community facebook.com/cardinalhealthfoundation 2016 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO and ESSENTIAL TO CARE are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. Lit. No. 5CR _4 (07/2016) 6
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