Health Matters Nov. 2015

Health Matters To Help People Be Healthy

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November 2015

What the heart wants

Collaborative aids HaysMed, patients after heart attack or stroke

HaysMed

Provided to our patrons free of charge

Photo by JOLIE GREEN

The Hays Medical Center DeBakey Heart Institute.

What is the collaborative?

H ays Medical Center recently teamed with the University of Kansas Hospital to improve overall outcomes for northwest Kansas patients who have suffered a heart attack or stroke.

Through the support of a $12.5 million federal Healthcare Innovation Award, the Kansas Heart and Stroke Collaborative is hard at work to establish important changes for patients in rural areas.

“It fulfills one of the missions of the University of Kansas Hospital, which is to improve the quality of health care in Kansas,” said Dr. Robert Moser, M.D., KHSC executive director.

Moser The grant was awarded to the University Kansas Hospital, and HaysMed is its partner in administrating it, according to Terry Siek, vice president of patient care services and chief nursing officer at HaysMed. “We have the advantage of a lot of money to help the region that no one else has,” said Kevin Myers, director of emergency services at HaysMed. “Northwest Kansas is going to change parts of health care, which is exciting.”

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To make this happen, the University of Kansas Hospital has partnered with HaysMed, and additionally 13 other care facilities including Cheyenne County Hospital, Citizens Medical Center Inc., First Care Clinic Inc., Gove County Medical Center, Ness County Hospital District No. 2, Norton County Hospital, Pawnee Valley Community Hospital, Phillips County Hospital, Rooks County Health Center, Russell Regional Hospital, Sheridan County Health Complex, St. Rose Health Center and Trego County-Lemke Memorial Hospital.

“We are here to support the regional hospitals,” Siek said. “The collaborative is helping Myers them look at their internal process and is giving them protocols that are locally relevant and make sense for that facility.”

In the rural communities where the partnered care facilities are located, the mortality rate for stroke and heart attack victims is highest. The goal is to ultimately decrease these deaths by 20 percent, according to Moser.

See COLLABORATIVE, page 5

What It Is

Health Matters

Patient benefits abound

T

hanks to the high levels of research, education and action underway through the Kansas Heart and Stroke Collaborative, northwest Kansas patients are seeing direct results and more positive outcomes when it comes to health care.

Medical care is no longer the same for those who choose to live in rural areas, who are now receiving an enhanced level of urgency, quality of care and knowledge of symptoms.

“Care for a heart attack or stroke victim should not be determined by where you live; it should be the same everywhere,” said Kevin Myers, director of emergency services at HaysMed. “We want to reassure the patient they are receiving the same process as they would anywhere else.”

The KHSC process initially begins with a patient recognizing the signs and symptoms of a heart attack or stroke.

“This is something that continues to be a challenge as we work to get patients to call 911 and get to their local hospitals,” said Jodi Schmidt, KHSC operations director.

Timing can be critical when it comes to a diagnosis, so when the patient arrives at the health facility, staff follows a set of protocols and guidelines designed to reduce the time it takes to reach a definitive diagnosis and treatment.

“Specialists in Hays, the University of Kansas Hospital or the nearest appropriate facility are then contacted,” Schmidt said. “With real-time guidance and support from specialists, and local STEMI (ST Elevation Myocardial Infarction) and Stroke Boot Camp trainings in each community, the time to treatment is shortened.”

A big part of the KHSC model was created to save patients money through transitional care management and chronic care management services.

When the patient is ready to be discharged from the hospital, a transitional care manager, or advanced practice nurse practitioner, offers to see the patient in their home to assist with medications, answer any questions and make Health Matters

Photos by JOLIE GREEN

Training manager Shelley Boden, right, teaches health coach Jenny Dreher how to use the Chronic Care Management Document tool at the Kansas Heart and Stroke Collaborative office in Hays.

IT manager James Sell demonstrates taking a photograph of an EKG to send to the Hays Medical Center emergency room.

certain the patient has the necessary support needed to keep their follow-up appointments, according to Schmidt.

Benefits

“This visit happens within seven to 14 days, and the telephone or e-mail support continues for 30 days after the patient leaves the hospital,” Schmidt said.

The opportunity to continue working with local health coaches is then offered to the patient.

Health coaches can help patients continue to manage their prescriptions, assess health-care needs, communicate with family to answer questions and concerns, and by generally assisting local providers in helping patients between routine clinic visits, according to Schmidt.

“The health coaches are there to help with patient education, engagement and to increase the patient’s self-management skills,” Moser said. “We’ve hired 10 in the 14 counties we’re involved in, and we have the other four identified and we’ll be bringing them on.”

In addition to health coaches, in order to continue advancing patient care, the KHSC has office space in Hays, office staff, experts in the field, leaders and numerous doctors available as a resource.

“Those in rural communities are going to get the best care possible,” Myers said.

“It is not the same as it used to be.”

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Photos by JOLIE GREEN

Hays Medical Center health coach Jenny Dreher places a pulse oximeter on a patient’s finger during a mock home visit in Hays.

Acknowledging symptoms, taking action

K

ansas Heart and Stroke Collaborative professionals continuously emphasize the importance of symptom understanding and acknowledgment.

To increase the chance of survival for heart attack and stroke victims, the ability to recognize the warning signs is critical.

According to KHSC Executive Director Dr. Robert Moser, many have symptoms for days, which can go away, so patients wait longer than they should to seek medical attention.

“We’ve been really pushing the basics — recognizing symptoms and community education,” said Kevin Myers, director of emergency services at HaysMed. According to Myers, denial is one of the top problems with patients.

“Sometimes patients will have chest pressure, they may even put their hand on their chest, but they will simply think, ‘Oh, no, that can’t be a heart attack,’“ he said.

See SYMPTOMS, page 5 Page 4

Jessica Pfeifer, right, APRN with the Kansas Heart and Stroke Collaborative in Hays, demonstrates a home visit with a mock patient.

Symptoms

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COLLABORATIVE, from page 2 “In rural areas, sometimes there is a lack of resources,” Myers said. “Sometimes, recognizing the symptoms is the problem.”

Additionally, the cost to receive care in the areas is higher than the average national cost.

“Through this grant, we can express our feelings on these matters and let people know how to make changes to ultimately better things for everyone,” Myers said.

That is the goal of KHSC — to help acknowledge and improve these feats, whether it’s through increasing education, technology, networking or a collaboration of resources.

According to Myers, there are a lot of people focused on these goals and working hard to use the new care delivery model, which will reduce medical costs and improve clinical outcomes.

“We want the patient to have the best possible chance if they’re having a heart attack or a stroke,” Myers said.

“We’ve already started seeing an impact on that.”

The results are showing improvement

Photo by JOLIE GREEN

Office manager Rachel Cronn prepares paperwork at the Kansas Heart and Stroke Collaborative office in Hays.

in education, awareness, payment, doctor office visits, hospital stays and, most importantly, survival.

“It’s really a cool thing,” Myers said.

“The grant is coming up with new ideas, new rules, taking the rules we have and challenging them, to see what would make medicine better for everyone.”

SYMPTOMS, from page 4 Excuses, denial and playing the waiting game can be deadly, and when it comes down to it, it’s better to be safe than sorry.

“You’ll usually have some kind of warning sign,” Myers said. “It’s all about recognizing those and seeing a doctor.”

If patients take their symptoms more seriously, doctors have a much higher chance of preventing what could come next.

For a heart attack, nausea, sweating and Siek chest pressure are common symptoms, along with radiating pain to the jaw or arm.

“Those are kind of classic symptoms,” Myers said.

Stroke patients often have different, more physically visible symptoms, including facial droop or a one-sided weakness.

Health Matters

The DeBakey Heart Institute is on the campus of Hays Medical Center.

“A few many don’t realize are confusion and dizziness,” Myers said. “We are now linking dizziness to strokes all the time.”

Many northwest Kansas communities are participating in outreach proj-

KHSC

ects to help educate citizens on the signs, and helping spread the awareness is at the top of KHSC’s list.

“This is one phase that is going to be very important,” Moser said. “We are very focused on looking across communities to see how we can help with the awareness and education component.”

Diet, exercise, medication and a strong relationship with a personal physician or provider is key, according to Jodi Schmidt, KHSC operations director.

“Learning to recognize the signs and symptoms of a heart attack or stroke, and seeking immediate care rather than simply waiting and hoping symptoms will go away, is critically important,” she said.

“It can mean the difference between going home several days after, with no long-term debilitation, versus a long road of recovery.”

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