Netsmart CareThreads
Netsmart CareThreads

Episode · 1 year ago

4. #hospice Caring for COVID-19 Patients

ABOUT THIS EPISODE

In COVID hotspots, hospitals and other health care providers quickly rose to the occasion this spring when faced with a rapid influx of new patients. Catholic Home Care & Good Shepherd Hospice on Long Island cared for more than 1,100 COVID-positive patients and 400 hospice patients who are COVID positive. They've also kept a rehospitalization rate to less than 1%. How did they do it? 

  

Kim Kranz, president at Catholic Home Care & Good Shepherd Hospice, joined this episode of NetSmart CareThreads to talk about what's involved in taking care of patients with COVID-19. 

  

What we discussed with Kim: 

  

- The challenges of scaling up services rapidly during a pandemic 

  

- Advice for home health organizations in new COVID hotspots 

  

- How to provide solutions during a time of shortage in primary medicine 

  

If you want to hear more episodes like this one, look for the Netsmart CareThreads podcast on Apple Podcasts, Google Podcasts, Spotify or Stitcher.

Welcome in that smart care, threads, apodcast were human services and postocute leaders across the healthcarecontinuum come together to discuss industry trends, challenges andopportunities. Listen is we uncover real stories about how to innovate andimprove the quality of care to the communities we serve? Let's get intothe show so good afternoon today on net smart care threads. This is JenniferSherman and I'm joined by Kim Craans President of Catholic home care andgood shepherd hospice of caplikel services in Long Island, New York Kim.Thank you for joining me today. Oh My pleasure JEM. Thanks for having meyou're welcome. So your organization is taking care of over one thousand,actually eleven hundred covid positive patients and are caring for fourhundred hostiss patients who are covid positive you've also kept arehospitalization rate to less than one...

...percent for the COVID patients. You'veserved that's fantastic yeah. The team has done a remarkable job and you knowwe very quickly had to rise to the occasion as the largest post acuteprovider on Long Island, to make sure that we could help not only ourhospital system but all the hospitals across Long Island Jem in making surethat you know they would have capacity for the increased number of covidpatients coming in. So we worked very very quickly with physicians and alsoworking to make sure that patients were being seen as quickly as possible andreally looked at where the gaps were throughout, like I said, the healthcaresystems to identify what the needs would be based on. You know based ontheir population who they were serving.

So you know what we found is that, ofcourse, with you know the majority of the homehealth organizations across thecountry. The surgeries you know stopped. I mean that was Mantateng in the stateof New York, Tou, the Department of Health, and you know, through theexecutive orders of Qomo, we saw they stopped, and so we saw the populationshift and we really tried to identify with the discharged planners. Wherewere the gaps, what was needed? What equipment was needed and, like I said,just worked overnight- to identify with the physicians with the hospitalist,how we could safely discharge these patients home, who were still very,very sick and combined home healthcare visits, physician, Tella, medicinevisits and then remote, Tella, health monitoring, wow, that's a hugechallenge, and I'm just so incredibly...

...excited that you kept that to less thanone percent for their re hospitalization rate. Can you sharesome of I know you talk through a lot of the challenges, but what was yourbiggest challenge that you had to overcome in order to serve thosepatients? Never in my wildest dreams did I thinkthat the lack of oxygen concentrators was going to be the holdup todischarging patients from the hospital. We saw that a lot of work was beingdone to make sure that there were enough ventilators, and so I think thecompanies were working on building more ventilators to make sure that thehospitals throughout New York, city and Long Island, that indeed you know therewas enough ventilators and that increase youalization of ventelitors. Idon't know if anybody thought about how many oxygen concentrators we were goingto need for this patient population, and so that was the hold up Gen. thatwas the greatest challenge and that's...

...where we really came in as opposed tocute provider to say: Let us work with our GERBIL medical equipment companies.We literally got oxygen concentrators from other states who were notexperiencing the pure volume of patients infected with the virus. Herein Metro, New York and literally, you know, got those concentrators over hereto where we needed, and even you know, the the derbal medical equipmentcompanies came to our rescue once they secured more supplies, like I said fromother states, but weere all pullin we're all pulling from the same. Youknow the same supply chain and of course you know I would be remissed tosay that Ppe, you know, wasn't a challenge. Of course it was. You knowthe PPE was going to go to the hospitals first and what we found isthat, through the Department of Health O em in the state of New York, alongwith incredible community donors, that...

...really came to our rescue to help uswith personal protective equipment that truly truly helps so family members whowe have taken care of in the past. There was you know, connections fromrelatives, saying you're, always good to us. You know your served, my loveone on Good Shepherd hostise. What can we do for you and that's where you knowwe were able to reach out to community providers, even our nursing collegesand universities, even the PA schools and nurse Practitioner schools that ifthere was any equipment around lying around anywhere the Ppe we got it andthat trully truly helped us that's so fantastic. I love that teamwork orfamily behind your organization. So that is fantastic. So can you tell me Iknow you started talking about this,...

...but how has Catholic home care and goodshepherd houspice of Catholic health services? How have you provided suchgreat care? I mean you've obviouslythey Talkd to some of your challenges, butthat's one of the things that we've heard is the amazing care that youprovided. How did you maintain that? I think the first thing Jen when youhave the unexpected occur, is to work together with all of your employees,and the communication had to be. You know the very first priority andcommunicating with the staff who were afraid we had to recognize that andreally make sure that we could reassure them with CDC guidelines, theDepartment of Health guidelines being on top of that seven days a week. Youknow in the middle of the night, whenever information came out, weworked very fast to be able to get that...

...communication to our teams, so to say that it took team work is trulyan understatement. We worked with the managers work with the staff membersand the chief medical officer, and each director within the program and myselfcommunicated live with all of our employees and we have over a thousandemployees every single week and gave them opportunity opportunities throughzoom calls and conference calls to call us. You know with questions and toanswer those questions live based on their concerns, so that we could helpthem to help our patients and our families so again reassuring of the PPEmaking sure that those practices were stellar and that they weren't justhearing from leadership, but they were hearing from physicians andspecifically our chief medical officer, who did a fabulous job. Dr Carry onpage of keeping up to date with all the...

...all the research and the healthcarepractices that were coming through during the pandemic. That's fantasticand I have to say the Nice thing is. It appears that the New York Metrowariahas definitely gone down in numbers, but, as you know, the rest of thecountry is starting to experience. I maybe an incline. So what advice do youhave for the home health orgs? Who are in Covid hospots or the hospiceorganizations today and are struggling with some of the things same things youstruggled with? Well, I think first making sure thatyou have the personal protective equipment it may you know seem like itwas an easy feat for us, but it wasn't, and you know every single day you knowwe had that tount of inventory, so we knew where we were and working togetherwith the hospitals working together...

...with the assisted living facilities,the skilled nursing facilities and our community donors, utilizing thevolunteers for masks. We had to make sure that that inventory was presentgen in order to send our staff out. We were not going to send them out withoutmaking sure that they had the proper protection both for themselves and forthe patients and families we ha to stay really close to the Emr and make surethat we were following the practices and and making sure that we erescreening, every patient and family member prior to going in the home. Somaking sure we filled that information out in the demographics within thatsmart was so so important, so that they knew beforehand what they were walkinginto. It is critically important that youunderstand what the hospital staff are...

...experiencing. We went to the inside andthat wasn't just because we're part of a six hospital system, but we also wentto our partners at Nyu and our partners at Stony Brook and said what challengesare you facing so that we can help you? We found that Palative care andpolative medicine was of critical importance during the surge of Covidpatiencs, because critical conversations had occur had to occurwith the most seriously elderly, frail who also acquired the virus. So ourpowative care teams- and we have a strong impatient Poud of CARE programthat we run that Dr Carian pays. Our chief medical officer runs, so wereally trid to make sure that we were available and at the bedside with theclinitions, with the hospitalists in...

...our own chs facilities and thencommunicating with other palative care teams to identify their challenges inthe hospitals that we partner with, but that are not necessarily our own. Theother piece is to make sure you use as much telahealth or remote tellehealthmonitoring as you possibly can. We actually increased the number of unitsthat we had available during e the heat of the pandemic. In making sure that wecould be monitoring the patient's pull sox multiple times a day, so you knowthe protocols and the practices that we had in place before didn't necessarilyapply to the situation we were in because again, it was critical not tohave those patients go back to the hospital and boy haven't we learned.Haven't we learned to change the way we practice some of our our best practicesand healthcare protocols with the...

...seriously ill at home, so that we cancontinue to greet decrease that rehospitalization rate, because afterall, isn't that our job as homehouse providers? The other piece that welearned our lesson from, is that we've got to make sure we are great stuartsof partnering, with our Physicians, we're often in the situation. We reallycall a physician when there's a problem and instead we need them to be a partof that planof care part of that visit right in the beginning, making surethat if they can do a tella medicine visit and even though the tellemedicine visits are decreasing across the country, and I have been readingthe literature about that that shouldn't go away. That may be theeasiest and the fastest way for a physician to identify where changesneed to occur with that patient' health...

...care, and we need to make sure that wepartner with the physicians that were not out there on our own and expectedto do everything. So again, I think partnering, with the Physicians Makingsure that the physician visit post discharged is within forty eight toseventy two hours. Again, that's a huge challenge across the United States withhe shortage in primary medicine, but we should continue to try to work towardsthat and be part of that solution with our physician partners and with ourhealth care systems. Fantastic advice. Thank you for sharingyour experiences and what you've done. Thank you CIM. So much for your time. Ithink this information is going to really resonate with the rest of ourorganization and and the rest of the industry. So thank you so much. Iappreciate your time and appreciate our partnership. Oh thank you! So MuchJenit with my pleasure and that smart,...

...we understand the challenges facingprovider organizations. Our team will help you navigate changing value, basedcare models with solutions and services that make person centerd care orreality will equip you with technology and services that provide holistic,real time. Views of Care Histories that inform better decision making andbetter outcomes visit us today at ntstcom net smart serving you, so youcan serve others thanks for listening to the net smart carethreads podcastthrough collaboration and conversation, we can work together to make healthcaremore connected than ever before and better support the communities we serveto ensure you never miss an episode. Please subscribe to the show in yourfavorite podcast player, if you use apple, podcast, we'd love for you togive us a quick rating for the show just happ the number of stars that youthink the podcast deserves. Until next time,.

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