South Florida Hospital News
Monday May 25, 2020
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February 2007 - Volume 3 - Issue 8

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An Insiders View: How Important Is Coordinated Care?

As healthcare professionals, our goal is to provide the best possible care for our patients. A multi-disciplinary approach can help ensure that all patients’ care needs are identified and appropriately treated; but, what happens when care is disjointed, unorganized, and uncoordinated? Do patients notice when they receive fragmented care? Do they understand the implications? Is it important to them that their primary care physician is aware of each sub-specialist’s care plan? Who is ultimately responsible for maintaining care coordination?

These questions are extremely important, especially in cardiovascular services, where patients typically have overlapping disease processes, and receive care from multiple physicians in varied disciplines. At Corazon, we assist many organizations with evaluating their cardiovascular patient care processes, and work with them to design and implement improvement plans that will provide more efficient care across the continuum. Indeed, a coordinated approach can assure positive clinical outcomes, reduce the cost of care, and lead to satisfied customers – ideally driving market share growth. How hospitals, health systems, and physicians are able to operationalize a coordinated approach to care is a key question … Indeed, the devil is in the detail …

I recently had the misfortune of experiencing uncoordinated cardiac care, and found myself extremely frustrated with the healthcare systems and processes that I have worked so hard to improve during my career.

In my role as a consultant, I spend a lot of time on airplanes—a veteran "road warrior." Recently, I became ill on a flight returning from a client visit. I was sick and a bit frightened as I made an immediate appointment to see my Primary Care Physician (PCP) to determine what was going on. After the typical diagnostic test and blood work, a referral to a cardiologist was made. After my visit with the cardiologist, additional testing was ordered to evaluate my ongoing symptoms.

Working in the healthcare field, I felt in control of my situation. What followed made me doubt my level of control and raised my level of concern as a very informed healthcare consumer. I experienced increased levels of complex diagnostic testing and lab work as I was referred from one sub-specialist to another. I, like many other members of my generation, expect immediate access to results and an understanding of next steps so we can plan our busy lives around the inconvenience of healthcare issues.

Through this process I was hit with the stark reality that the healthcare system did not react with the sense of urgency that I expected. Results were not available in a timely manner, communication between the sub-specialists did not happen, and my primary care physician who is deemed to be the "coordinator of care" was not viewed as the "captain of the ship."

I’m sure you can imagine my frustration with this scenario. Being a member of the healthcare field, I knew what needed to occur to improve the coordination of my care plan, so I took the initiative to meet with my PCP in order to ensure that I was receiving well-coordinated care in a timely manner. But, how would a patient without a healthcare background handle this situation? Could non-compliant patients with frequent readmissions and/or frequent return visits to their primary care physicians be the result of fragmented care?

Corazon recommends the following strategies to improve the care processes at your organization, thereby improving the cost and quality of cardiovascular care:

Involve Case Management – Many hospitals have case managers who work closely with the physicians to coordinate inpatient care; however, my experience has led me to realize that a counterpart in the outpatient setting would improve care plan integration.

Involve System PCPs – Corazon believes that PCPs oftentimes serve as the ‘gatekeeper’ for cardiac disease, and should play an active role in making sure their patients receive coordinated care. This will help reduce the number of readmissions and frequent visits to PCP offices, while hopefully resulting in decreased cost of care.

Ensure outpatient testing is timely – One of the challenges hospitals face is scheduling out-patient procedures. Through close evaluation of the processes patients go through when trying to schedule examinations, hospitals can work to improve patient throughput and improve satisfaction. Timely report submission to the PCP also plays a key role in this process. Corazon recommends that the scheduling processes, staffing ratios, throughput, and physician interpretation turnaround times are continually monitored.

Realizing that hospitals have a limited impact on the care coordination of patients in the outpatient setting, it is essential that hospitals do as much as possible to work with physicians to provide timely services and rapid turnaround on reports. Customer satisfaction, both internally and externally, will help the coordination process improve.

By working with physicians to provide coordinated care, patient satisfaction will no doubt increase. Hospitals will likewise benefit from process improvement, decreased unnecessary readmission rates, and less frequent overlaps in care between and among specialty physicians and PCPs.

Personally, my care was finally coordinated, and I am well on my way to recovery. With close care coordination and medical management at the hospital, along with patient lifestyle modifications, we can all work together to reduce the risks and incidence of advanced cardiac disease. At Corazon, we will continue to work with organizations across the country to improve their care process so that other patients won’t experience similar frustrations. Based on this experience, I am even more motivated to work with my colleagues and clients to create outstanding cardiovascular programs – in terms of efficient operations – so as to ensure timely, high-quality care for all.

For readers not in the healthcare field, I encourage you to use a network of friends and family who are involved in healthcare as resources and advocates should the need arise. I am sure they would be willing to give advice, and even help navigate the often complex healthcare bureaucracy system.

Wishing you a healthy and prosperous 2007!

Kevin is a Consultant at Corazon, a national leader in specialized consulting and recruitment services for CV program development. For more information, call (412) 364-8200 or visit www.corazoninc.com.
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