The Goldendale Sentinel - Headlines & History since 1879

By Lou Marzeles

KVH, Mayo Clinic, Select Medical launch enhanced Transitional Care program


Goldendale Sentinel.

KVH's new program will assist post-acute care patients before they return home.

An association between Klickitat Valley Health (KVH) in Goldendale and the world-renowned Mayo Clinic has resulted in the formation of a new program at KVH called enhanced Transitional Care.

A formal announcement of the program is scheduled for Thursday, Sept. 1, at noon at a special Goldendale Chamber of Commerce lunch at the hospital (310 Roosevelt Ave.). Among the speakers will be Dr. Mark Lindsay, medical director of Allevant Solutions, a venture formed between the Mayo Clinic and Select Medical that focuses on post-acute medical care in rural hospitals.

The Transitional Care program is being launched in only two Washington State hospitals at this time-both of them in Klickitat County, at KVH and at Skyline in White Salmon.

The program, covered under Medicare's Swing Bed provision, facilitates transitions for patients who have completed acute medical care but are not yet medically ready to be released home. Aimed at rural critical care hospitals with 25 or fewer beds, it provides higher levels of patient attention than can be typically found in larger urban hospitals-and that in itself is seen as likely to draw patients from far distances to Goldendale as well as ensuring ample attention for local patients.

"I definitely have a place in my heart to try to take care of this segment of the population," says KVH CEO Leslie Hiebert. "And although we can't be a nursing home, this is a piece of it, helping them transition from the hospital to home. If they're in a larger acute care facility where they've surgery or they've had a stroke, this is one little piece that we can offer in transition. I really feel good about trying to offer that service to be a part of that community where we don't have assisted living. If we can help support them to where they are really ready to go home and succeed, then I'm excited to do that."

"We're really focusing in on trying to improve outcomes for patients who are recovering from an acute illness or surgery," states Dr. Mark Lindsay, medical director of Allevant that offers the program through a collaborative venture between the Mayo Clinic and Secure Medical. "So we have put together some key processes, specifically training and education, transparency with important outcome measures. Key processes that included bedside rounds with patient, family, and care team. We began marketing this to our patients who were in the larger tertiary urban hospitals, and we had a lot of success. We had very excellent outcomes, we had very strong patient satisfaction-the vast majority of patients strongly recommended the program, would recommend the program to others-more than 90 percent on both of those measures. And we had a very low readmission rate."

All of these outcomes are remarkable against any standard today, but that last one is particularly significant. "That is a big issue across the country," Lindsay says, referring to readmission rates. "Approximately one in five Medicare patients who are admitted to the skilled nursing facilities are readmitted, at cost in the billions of dollars. So being able to reduce the readmission rate is a very big benefit."

The benefits just keep piling up. "The other nice thing that happened is that [the program] allows a lot of patients to recover closer to home," Lindsay adds. "Another thing that we noticed is that we had very high employee satisfaction when we began this program in critical access hospitals. We had some initial success in Wisconsin and we were able to spread that success to all the critical access hospitals in Mayo, 11 of the 12 critical access hospitals in Mayo. Those hospitals were in Minnesota, Wisconsin, and Iowa. So with that success, that really made a big benefit to the Mayo Clinic, the big hospital in Rochester [Minn.], by being able to get patients out sooner, getting patients closer to home and lowering the readmission rate, and it also has some benefit financially to the critical access hospital. So it is a win for everybody involved. It is a win for the tertiary hospitals that have trouble placing patients, it is a win for the critical access hospitals that tend to have a very low census, but most importantly it is a win for the patients and the families, being able to be cared for closer to home in a more homelike environment. Oftentimes being in the big hospital is not the best place to recover when you are really ill. Often times that more homelike environment that is available in a facility like KVH, for example, really is beneficial."

So how did KVH's association with a household-name medical organization with some 4,500 employees come about? "I think the first time I heard about the program was at a conference," recalls Hiebert. "I went to one of their sessions to learn more about it. I had been considering it." Hiebert's connection with the presenter led to discussions that developed over the past year.

"We actively marketed," Lindsay points out. "After we had success with Mayo, we formed a new company called Allevant, which is a joint venture between Mayo Clinic and Select Medical. Our whole emphasis is to promote the transitional care program and high-quality post-acute care programs. We do support nursing homes as well. One of our main focuses is the transitional care program in critical access hospitals. We are doing work in Washington State, Oregon, Montana, Illinois, Kansas, and Minnesota. KVH has gone through all of the important key training and education, so they are launching the transitional care program. They are ready, they have everything in place, they are really set up to do this well. We are super excited about what we believe, what we know they are going to accomplish. This is the type of program that you would want for your family member. That higher level nurse staffing, the ability to have therapy, the ability onsite lab and radiology, the ability for physicians to be available if there is acute change in condition-all of those things are really a high level of care which we know will reduce readmission rate and will promote patients to getting to their highest level of independence."

Lindsay adds the KVH Transitional Care program is ideally suited to an area such as Goldendale, with a high percentage of seniors. "Most of the people who utilize the transitional care programs are going to be Medicare age, over 65," he says. "Those are the patients who are more likely to need care after acute hospitalization. The other thing is in our experience that we have found that patients will travel pretty large distances to receive this higher level care. So it is not unusual in our experience for patients to go a distance to receive this higher level of care. Certainly our main goal is to provide this care to patients that are from that local community, but we believe that because this higher level of care is not necessarily available nationwide that patients will travel a distance to come to this higher level of care."


Dr. Mark Lindsay is Allevant's medical director.

That means it's not unreasonable to presume patients will come to KVH from Yakima, Portland, The Dalles. "This is going to be a big benefit to the Portland area," he points out. "Portland hospitals have a need for high-quality post-acute care, so this is a really big win for them as well. That is what is so nice about it; it is a tremendous opportunity for the those hospitals, even for Mid Columbia, when patients are recovering from an illness or surgery for them to be able to come to transitional care. It does benefit Mid Columbia and The Dalles, it will also benefit the acute-care hospitals in Portland as well as Yakima. So it is a really big win to have this available."

Lindsay is strong in his support not just of the program but of KVH-and CEO Hiebert-as well. "I think keeping these critical access hospitals alive is critical," he says. "This is a program that benefits everyone. Leslie Hiebert's leadership has been essential. This would not happen without Leslie's leadership. So we are excited about this moving forward, and we really believe that this can really be a strong benefit for the community."


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