St. Luke’s healthbeat for physicians
The patient is in… T
he Physician’s Clinic of Iowa (PCI) Medical Pavilion joins specialty healthcare services under one roof for patient convenience and improved coordination of services. In healthcare, a trip to a specialist is often just the beginning for patients. One specialist can lead to another and before long the stream of necessary healthcare-related visits can send a patient through a maze of locations for services. Consolidating physician sprawl is the idea behind the new PCI Medical Pavilion. By bringing together specialty medical and surgical care under one roof, patients receive better service. Appointments are more efficient, providers are easier to access and patients receive ancillary services on site, such as the pharmacy, laboratory and diagnostic imaging.
Helen G. Nassif Community Cancer Center of Iowa The Community Cancer Center will be located on the second floor of the PCI Medical Pavilion. It will include exam rooms, physician office space, dedicated education and family meeting rooms and space for wellness programs. The phone number for physician referrals and patient requests will remain the same, 319/558-4876.
A1
Medical district news Several St. Luke’s services relocate A3
Dialysis options expand DaVita comes to Cedar Rapids A4
Inpatient hospice care St. Luke’s opens new Inpatient Hospice Unit A6
Top 50 Heart Hospital St. Luke’s recognized for excellent cardiovascular care
“More than 80 percent of cancer care is completed in the outpatient setting. Locating the Community continued
, P.O. Box 3026 Cedar Rapids, IA 52406-3026 319/369-7211 stlukesmedstaff.com
St. Luke’s Hospital – A1
Located on 10th Street SE, between First and Third Avenues, the PCI Medical Pavilion is a $47 million, three-story, 221,000-square-foot facility scheduled to open in April 2013. It provides a mall-like setting for a variety of healthcare providers and a community education center for screenings, classes and events. Each clinic has its own “storefront,” and an atrium stretching from end to end provides an open, easy-to-movethrough layout. Skywalks connect the building to Surgery Center
Cedar Rapids and a parking garage. The main entrances have patient drop-off canopies. PCI describes the pavilion as a new way to deliver specialty medical and surgical care. All PCI physicians will be located in the building along with the Helen G. Nassif Community Cancer Center, St. Luke’s Breast and Bone Health and Cardiologists, L.C.
In this issue
Cancer Center in the PCI Medical Pavilion allows for integration among specialists and cancer support services,” explained Kimberly Ivester, administrative director for the Community Cancer Center. “Bringing providers together in one building will enhance communication between specialty providers, offer convenience for patient scheduling and allow for multidisciplinary sameday consults. Our proximity to specialists in the Medical Pavilion will allow us to fully integrate support services throughout the patient care continuum.” It’s a win-win situation for both patients and their primary care providers. “We want providers to see the Community Cancer Center as a central referral source for patients with a suspected or known cancer diagnosis. We are their hub, offering a single point of contact to connect patients and providers with specialists and numerous entities supporting patient care,” Ivester said. “We view providers in our community as our partners and an integral part of the patient’s care team. We want providers to use the resources of the Community Cancer Center to improve the quality of life for our mutual patients and help meet patients’ screening to survivorship needs.”
Cardiologists, L.C. Despite having two locations in Cedar Rapids, on 4th Avenue SE and on the 5th floor of St. Luke’s, Cardiologists, L.C. continues to outgrow their current office sites. The move to second floor in the PCI Medical Pavilion allows them to consolidate both Cedar Rapids locations, bring together their diagnostic services and upgrade equipment. “First of all, we will have more patient exam rooms, enabling physicians and midlevel providers to see patients on a more timely basis because of the increased capacity. Secondly, it will be much more convenient for patients to visit one site for all their cardiac needs. Thirdly, increased space allows for a more efficient work flow for the patients and staff and avoids duplication from two different
offices. Lastly, by being centrally located in the Medical Pavilion, we will be able to offer same-day appointments for referrals from other medical specialists in the facility. This is a great convenience for patients and families,” said Todd Langager, MD, Cardiologists, L.C. “This state-of-the-art office facility allows us to provide timely, efficient and more coordinated care than we presently are capable of providing,” Langager explained. Other businesses moving to the Medical Pavilion are Clark and Associates Prosthetics and Orthotics, CarePro Pharmacy and Hy-Vee/Caribou Coffee café. Grand opening and facility tours are being planned for April 2013. For more information on specific dates, go to pcibuildingbettercare.com
Physician’s Clinic of Iowa (PCI) Medical Pavilion 2nd Floor
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Helen G. Nassif Community Cancer Center of Iowa St. Luke’s Breast & Bone Health
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– St. Luke’s Hospital
St. Luke’s Breast and Bone Health Adjacent to the Community Cancer Center, St. Luke’s Breast and Bone Health will be in close proximity to specialists who serve their patients. “The location will allow us to work more closely with our physician partners and improve upon detection to diagnosis and treatment time, focusing on getting women the answers they want quickly and accurately,” Ivester said. The phone number will remain the same, 319/369-7216.
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Cardiologists, LC
Main entrance
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10th Street SE
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St. Luke’s Breast and Bone Health, Cardiologists, L.C. and the Helen G. Nassif Community Cancer Center will be located on second floor of the new PCI Medical Pavilion, at 202 10th St. SE.
DaVita dialysis center partners with Internists P.C. (IPC) and St. Luke’s
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early 400,000 people in the U.S. depend on dialysis treatment for their survival, according to the National Kidney Foundation. With an aging population and an increasing incidence of end stage renal disease (ERSD), the demand for dialysis is expected to rise in our community. In order to meet that need and provide another dialysis option, IPC and St. Luke’s are partnering with DaVita Cedar Rapids. DaVita opened a new dialysis center at 5945 Council St. NE in February this year and received its Medicare certification in September. IPC and St. Luke’s are partners in offering a new choice for dialysis care. “ Patient choice is important, which is why DaVita is in Cedar Rapids giving high quality care,” said Tracy Seboldt, facility administrator for DaVita Cedar Rapids.
According to Seboldt, the resources DaVita offers patients set it apart from other dialysis centers. “DaVita takes every individual experience and looks at how to improve it. They ask, how can we make it better for the patient? It’s just amazing how much difference it makes for patients when a caregiver involved in their treatment shows them clinically why a particular solution is the best choice. DaVita offers great data and decisions are made with research and real-life experience behind it.”
Abha Saxena, MD, PhD, IPC Nephrologist DaVita Cedar Rapids medical director.
The admissions specialists focus on setting up treatments for every patient and work to meet their time, day and special care needs.
DaVita Cedar Rapids now serves 23 hemodialysis patients and 4 peritoneal dialysis patients. “DaVita provides dialysis, but is not just about dialysis. DaVita is about improving our patients’ quality of life. By offering personalized care, highly trained clinical teams and the broadest array of treatment options, we are helping our patients live healthier, longer, fuller lives,” Seboldt said. DaVita is a leading provider of kidney care in the United States, consistently demonstrating clinical outcomes that are among the best in the nation, with clinical outcomes improving 11 years in a row. To admit a patient to DaVita Cedar Rapids, call 866/475-7757. For questions, call 319/294-7088.
, P.O. Box 3026 Cedar Rapids, IA 52406-3026 319/369-7211 stlukesmedstaff.com
St. Luke’s Hospital – A3
IPC Nephrologist Abha Saxena, MD, PhD, is the DaVita Cedar Rapids medical director. Other members of the personalized care team include Paramesh Ramadugu, MD; Adisa Kudumovic, ARNP; Jody Hornickel, ARNP; Deborah Hooker, SW; Emily Ford, RD; Tracy Seboldt, RN, BAN, CDN; Sandra Okones, RN; Connie Koenigsfeld, PD RN; Joanna Schmidt, clinical services specialist.
The center has three patient care technicians, a biomedical technician and an insurance counselor that can assist patients and their family members with Medicare/Medicaid and employee group health plans. DaVita’s guest services also assists patients with finding dialysis services while traveling.
Inpatient hospice care O
ur community’s first and only dedicated Hospice Inpatient Unit opens in St. Luke’s Hospital this February.
Virtually equivalent to embedding a hospice house within the walls of St. Luke’s, the Hospice Inpatient Unit is a homelike environment intentionally designed to provide the best care for those who are imminently dying. “Sometimes the best place for a patient to receive care is in the hospital, because the patient requires more intervention to be comfortable than can be provided at home,” said James Bell, MD, medical director, St. Luke’s Hospice.
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– St. Luke’s Hospital
Opening Feb. 11, 2013, the hospice within the hospital improves endof-life care for patients who must remain in the hospital for their last days. Patient rooms are oversized and equipped with sleeper sofas. Family space within the unit includes a kitchen and laundry. There are also meeting rooms and quiet spaces for families to use. In addition to the peaceful, homelike environment, patients and families using the
Hospice Inpatient Unit benefit from a specialized staff trained in hospice care.
Transferring patients Patients will transfer to the Hospice Inpatient Unit when their primary and/or hospital physicians, together with the hospice medical director, determine it’s appropriate after
“ Our hospice providers are available to serve as either consulting or primary physicians, especially for difficult management situations or after-hours calls.” James Bell, MD, St. Luke’s Hospice and Palliative Care
“When a patient’s goal shifts from aggressive or curative care to a comfort focus and their needs require the intensity of the inpatient realm – or they are too unstable for transfer – then general inpatient hospice care is appropriate. Of course, many if not most patients want to be at home, and if that is possible, we will absolutely advocate for getting them there,” Bell said.
discussing patient care goals and options. “Ultimately, St. Luke’s Hospice is responsible for validating the appropriateness of initiating and continuing inpatient hospice care,” Bell explained. “We want to make the experience as smooth as possible for patients and providers. If a provider is considering inpatient hospice for a patient who is already in the hospital or from the ED, they can call Hospice (319/3697744) or put an order in EPIC for an inpatient consult to hospice to start the process. It’s up to the patient and family ultimately to determine who will be the primary physician for hospice care. We are very happy to have providers serve as the primary physician, especially for those patients with whom they have a special bond. Our hospice providers are available to serve as either consulting or primary physicians, especially for difficult management situations or after-hours calls,” Bell said. When patients are moved directly to the
Hospice charges Medicare and private insurance and provides free hospice care to patients when services are not covered. Services include: • Nursing • Social work • Chaplain • Aides • Music, pet and massage therapy • Physical, occupational or speech therapy
unit from home, the process will be planned ahead with communication to and from providers.
Benefits of inpatient care Experts with hospice training staff the Hospice Inpatient Unit 24 hours a day, seven days a week. Examples of situations appropriate for hospice in a hospital environment are when pain medications must be adjusted quickly or monitored by healthcare providers or when a ventilator patient shifts from curative care to comfort care. High-level hospice care is also required when severe, life-threatening emergencies turn into situations from which the patient will not recover.
The Inpatient Hospice Unit offers additional services for hospice
to get symptoms under control. Residential care will be available for those occasional situations that are prolonged, especially if a patient becomes more stable. Patients and providers may still call hospice at 319/369-7744. The inpatient hospice nurse can help triage referrals, and there is always a provider available for questions.
St. Luke’s Hospice Inpatient Unit was made possible through generous contributions to St. Luke’s Health Care Foundation from community donors and St. Luke’s associates.
• Oxygen and expensive medications, such as chemotherapy (for symptom management, not curative) • Volunteer companionship
, P.O. Box 3026 Cedar Rapids, IA 52406-3026 319/369-7211 stlukesmedstaff.com
St. Luke’s Hospital – A5
Families with a loved one in hospice care can gather together more comfortably in the larger patient rooms, which also have sleeping accommodations and a private bathroom with shower for family members. There are small private rooms for family members to meet with healthcare providers and a large gathering space. There, grieving families can comfort one another and use amenities such as a computer station, kitchenette with dining area, laundry room and play area.
patients and their families. Respite care provides breaks for caregivers at home by caring for hospice patients for up to five days at a time. Current hospice patients suffering from severe pain or other symptoms can be admitted
St. Luke’s recognized for
excelling in heart care S
t. Luke's joins the Top 50 Cardiovascular Hospitals in the nation by providing the highest level of heart care with excellent outcomes – results that are unsurpassed in Cedar Rapids and the region. For the fourth time in the last ten years, St. Luke’s has been recognized for providing patients with top cardiovascular services while setting new standards for heart care. Truven Health Analytics, formerly Thomson Reuters, selected St. Luke’s as a Top 50 Cardiovascular Hospital from among 1,000 U.S. hospitals in its annual, quantitative study. St. Luke’s was one of three Iowa hospitals honored, and the only in eastern Iowa. “Given the objectivity of this award – it is truly a prestigious national honor for excellence in heart care,” said Ted Townsend, St. Luke's President and
CEO. “Hospitals do not pay for this award. It is earned based on rigorous analysis by Truven.” The study analyzed outcomes for patients with heart failure and heart attacks and for those who received coronary bypass surgery and percutaneous coronary interventions (PCI) such as angioplasties. Todd Langager, MD, Cardiologists, L.C. said, “This is an important accomplishment because hospitals that achieve this designation are high-performing hospitals: They have significantly better 30-day survival rates, lower readmission rates for heart attack and heart failure patients, while at the same time discharging patients sooner with the result that they achieve both higher quality outcomes as well as lower costs. In addition, hospitals who achieve this designation are more likely to follow recommended protocols.”
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– St. Luke’s Hospital
The study showed a general trend that U.S. hospitals are improving
cardiovascular outcomes nationwide. Ninety-six percent of cardiovascular inpatients survive and remain complication-free. However, the 50 Top Heart Hospitals out-perform their peers in the following way: • Lower death rates: 41 percent fewer deaths than expected, given patient severity • Patients experience lower complication indices, including a 37 percent lower rate of heart failure complications • Spend approximately $3,500 less per bypass surgery case; $1,000 less per PCI patient • Have significantly better 30-day survival rates • Maintain lower readmission rates after 30 days • Release bypass patients nearly a day sooner than their peers; heart attack and heart failure patients are released about ¾ day sooner Jean Chenoweth, senior vice president for performance improvement and the 100 Top Hospitals® program at Truven Health Analytics, said, “The hospitals in this study have achieved
“This is very much a team approach. By adhering to known quality metrics and utilizing the resources and processes developed in a collaborative environment, we have been able to demonstrate St. Luke’s patients have better outcomes.” Todd Langager, MD, Cardiologists, L.C.
5 50
HF 30-Day Readmission Rate (%) Performance measures from Truven’s analysis showed an overall improvement for cardiovascular outcomes at U.S. hospitals. Benchmark hospitals are the winners in the comparison group. Peer hospitals are the non-winners in the comparison group. AMI refers to acute myocardial infarction patients. HF refers to heart failure patients.
28.0 24.0
23.4 22.9 23.9
20.9
22.6 24.2
23.7 24.2 20.9
Percent
20.0 16.0 12.0 8.0 4.0 0.0
2010
2012
Benchmark Median
Peer Median
AMI Risk-Adjusted Mortality Index Observed to Expected Index
higher levels of care and efficiency than their peers, demonstrating incredibly strong focus by cardiologists, cardiovascular surgeons, and cardiovascular service administrators and staff on basic care and outcomes.”
2011
St. Luke's
1.20 1.10 1.00
0.99
1.01
0.92
0.86
0.90
“I think the biggest reason for the 0.80 success of St. Luke’s Cardiovascular 0.70 program – both medical and 0.60 surgical – is the multidisciplinary 0.50 approach that we use with 0.40 engaged physicians, dedicated and highly competent staff and an administration that provides the resources, infrastructure and support for all involved to provide state-of-the-art care for cardiac HOSPITAL HEART 24.0 patients,” Langager said. “This is very much a team approach with 20.0 active involvement from every 16.0 individual. By adhering to known quality metrics and utilizing the 12.0 resources and processes developed 8.0 in a collaborative environment, we have been able to demonstrate 4.0 St. Luke’s patients have better 0.0 outcomes. And that is confirmed by being designated as a Top 50 Heart Hospital.”
1.01
0.99
0.83 0.69 0.62
2010 St. Luke's
2011 Benchmark Median
2012 Peer Median
AMI 30-Day Readmission Rate (%) 18.4
19.6 19.6
18.3
18.6
18.7 19.3
Percent
HEART HOSPITAL
19.3 19.6
HOSPITAL
2010
50 2012
2011 Benchmark Median
2012 Peer Median
HEART HOSPITAL
The study, published in Modern Healthcare in October 2012, evaluated general and applicable specialty, short-term, acute care, non-federal U.S. hospitals treating a broad spectrum of cardiology patients. Truven Health Analytics researchers analyzed 2010 and 2011 Medicare Provider Analysis and Review (MedPAR) data, 2010 Medicare cost reports, and 2012 Centers for Medicare and Medicaid Services (CMS) Hospital Compare data. They scored hospitals in key performance areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost.
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St. Luke’s Hospital – A7
HOSPITAL
St. Luke's