South Florida Hospital News
Sunday May 24, 2020
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April 2006 - Volume 2 - Issue 10

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North Broward Hospital District Disease State Management Program

Many chronic conditions such as diabetes and asthma can be more easily managed with a few lifestyle changes, but where to begin? For many people, especially the uninsured or underserved, the tools and education needed to begin these lifestyle changes are simply out of reach. In order to meet this population’s needs and support them in their efforts to change their lifestyles, the North Broward Hospital District developed a disease management program that assists patients in further understanding their chronic condition.

Established in 1999 as part of the development of a provider service network, the program originally offered disease management assistance in diabetes. As the PSN began to develop more fully, asthma and HIV/AIDS programs were added. Soon after, programs for hypertension and congestive heart failure became part of the services offered in conjunction to a partnership with the Broward County government.

"The main goal is advocacy," said Gustavo Gonzalez, a senior case manager. "These are patients who usually have educational and cultural disparities, and the case manager juggles these issues to make sure the patient is educated."


Standing (l to r): Rose Marie Archer, Comprehensive Care Center; Gus Gonzalez, Disease State Management (DSM); Claudette Grant, Comprehensive Care Center; Burnie Mohorn and Paulet Royes, DSM
Seated (l to r) Yvonne Henry-Grant, clinical education; Lori Kessler and Suzette Marseille, DSM

Basically, the disease management program bridges the gap between the primary care physician and the patient by providing additional information and support so the patient may be better educated and have more control over his or her treatment. The primary care physician acts as the team leader, with the disease management team (consisting of healthcare professionals and case managers) supporting the patient and helping the patient take an active role in his or her healthcare.

"This program really helps patients be able to navigate through the health system," said Lori Kessler, the district director for the Disease State Management Program said.

Since patients with these conditions tend to have other co-morbidities, time with their physician is limited and usually focused on the most pressing situation. As part of the disease management program, patients are more involved in their day-to-day health management and are better able to make the most of their time at the doctor’s office.

"By being another set of eyes and helping the patient be a more active participant in their health, we’re making sure the patient can maximize their time with their primary care physician," Kessler said.

In addition, the disease management team is able to have more contact with the patient and therefore gets to know them on a more personal level. With this closer knowledge of their patients, it is easier for the case management teams to identify problem areas and personal nuances which in turn help them develop an individualized disease management plan.

NBHD has put forth every effort to identify the specific needs of the program’s target population. By shortening the educational programs to better fit the patients’ schedules, producing materials in different languages, creating materials that incorporate different cultural sensitivities and placing case managers in locations convenient to patients throughout the northern two thirds of Broward County, the District has taken the intimidation factor out of managing a disease and created a supportive, patient-friendly environment where patients can take control of their medical issues.

"We’ve tried to meet the needs of the community at a level patients can really absorb. We have the opportunity to offer guidance and provide answers to questions that come up after they leave the doctor's office," Kessler said.

She goes on to say that instead of telling patients what they need to do, they ask a patient what changes they can make to increase the sense of power and control the patient has over their healthcare.

For the professional healthcare worker, this program opens many new doors. The disease management program requires the expertise of many disciplines. Many health professionals – including nurses, respiratory therapist, pharmacists and dieticians – are able to find new career opportunities within disease management.

"Since disease management has been around, it has branched out to allow the nurses, respiratory therapists, nutritionists and pharmacists to go down another avenue where they can use all their skills and really send a strong message to the patient and be part of that educational team," Kessler said.

After seeing the benefit of the program on uninsured patients, NBHD decided to extend the disease management program to include all employees of the district.

"Most health professionals intellectually know what they need to do for their health," Kessler said. "The issue is taking it outside into the real world."

By having the case manager working with them, the employees are able to objectively evaluate their lifestyle to find solutions and launch an action plan more easily.

With such success, the program is sure to continue to grow, not only size, but in the programs it offers. Obesity management is expected to be added next. However, no matter what programs are available, the disease management team at North Broward Hospital District will continue to strive to provide personalized care for each patient.

"Every patient is an individual," Gonzalez said. "Whether it’s a language barrier, an educational barrier or a knowledge barrier, we’re there to fill in the gap where there is a need."

The program is located at all of the Ambulatory Health Centers located in the north parts of Broward County. To find a health center closest to the patient’s home, call the Ambulatory Centralized Scheduling number at (954) 712-3977.
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