Case Studies

Improving Population Health
Reducing Cost of Care
Enhancing the Patient Experience
Improving Provider Satisfaction
   -Select a Case Study-
  •    Coordinating Multidisciplinary Care
  •    Improving Patient Satisfaction
  •    Individualizing Care With Medication Management
  •    Mobilizing Telemedicine
  •    Optimizing Transitions of Care
COORDINATING MULTIDISCIPLINARY CARE

Desert Oasis Healthcare: Coordinating Interdisciplinary, Patient-centric Care With a Clinical Pharmacist-led Clinic

Overview

 

Desert Oasis Healthcare reduced the all-cause readmission rate and healthcare utilization by ensuring coordinated, continuous care and appropriate delegation across team members.1

The Challenge

 

Desert Oasis Healthcare sought to reduce healthcare utilization among patients with pulmonary diseases. These patients often require frequent ongoing care management that can be best supported by an interdisciplinary, coordinated care team through follow-up.2

The Approach

 
  • Placed clinical pharmacists at the center of an interdisciplinary model for ongoing, coordinated patient care2
  • Enrolled patients in the pulmonary clinic from all areas of health service2
  • Clinical pharmacists performed a variety of functions to coordinate care2:
    • –

      Assessment

    • –

      Medication management

    • –

      Education

    • –

      Care coordination

Outcomes

 
  • Total costs associated with all-cause healthcare utilization decreased 38.5% from $11.8 million in 2014 to $7.3 million after 20181
  • Readmissions decreased 65% from 165 in Year 1 to 58 in Year 41
 

1. Brazael T. Poster presented at: American Public Health Association Annual Meeting and Expo; March 21-25, 2019; Seattle WA. 2. Data on file. Boehringer lngelheim Pharmaceuticals, Inc.

IMPROVING PATIENT SATISFACTION

Bronson Methodist Hospital: Patient and Family Advisory Councils

Overview

 

Bronson Methodist Hospital achieved peak hospital performance by improving patient satisfaction.

The Challenge

 

Bronson Methodist Hospital decided to set a 10-year commitment to improve their service culture and implement a patient- and family-centered care model.

The Approach

 
  • Created a Patient and Family Advisory Council (PFAC) comprised of patients, family members, staff, and hospital administrators
  • Outlined expectations for staff, including information sharing, dignity, and collaboration
  • Providers customized care and modified their teaching style based on patient needs

Outcomes

 

Bronson Methodist Hospital achieved and maintained a 95% overall patient satisfaction rating.

For more information, visit  The Commonwealth Fund

 

McCarthy D. Case study: achieving a culture of patient- and family-centered care at Bronson Methodist Hospital. The Commonwealth Fund Website. https://www.commonwealthfund.org/publications/newsletter-article/case-study-achieving-culture-patient-and-family-centered-care. Accessed April 20, 2020.

INDIVIDUALIZING CARE WITH MEDICATION MANAGEMENT

Geisinger Health System: MTDM Clinic for COPD Management

Overview

 

Geisinger created a pharmacist-led medication management process to ensure treatment plans were developed based on GOLD Strategy Report recommendations.1

The Challenge

 

Geisinger wanted to reduce unnecessary COPD-related emergency department visits and hospital admissions while also improving care management and reducing the risk of exacerbations.1

The Approach

 

Developed the MTDM COPD Clinic in which MTDM pharmacists2:

  • Identified appropriate patients using analytics from the digital population health dashboard
  • Designed patient-centered, cost-effective medication regimens based on GOLD Strategy Report recommendations
  • Provided patient and provider education

Outcomes

 

Based on a review of 563 Geisinger patients with COPD, adherence to the GOLD guidelines for the initiation of triple therapy was nearly twice as likely when patients were referred to MTDM pharmacists, increasing from 34% to 71%.3

 

COPD=chronic obstructive pulmonary disease; GOLD=Global Initiative for Chronic Obstructive Lung Disease; MTDM=medication therapy disease management.

 

1. Data on file. Boehringer Ingelheim Pharmaceuticals, Inc. 2. Geisinger website. Geisinger Enterprise Pharmacy - 2019-2020 Year in Review. https://www.geisinger.org/-/media/onegeisinger/pdfs/pharmacy/1383-12099-pharmacy-annualreport2019-booklet12072020. Accessed April 14, 2021. 3. Lazevnick R, Kachmarsky M, Cebulko A. Evaluation of appropriate prescribing of Trelegy in COPD patients in Geisinger outpatient clinics. Poster presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 6-10, 2020; Online conference.

MOBILIZING TELEMEDICINE

Cleveland Clinic: Mobilizing Telemedicine for Proactive T2D and Other Chronic Disease Management

Overview

 

The Cleveland Clinic utilized existing telemedicine and shared medical appointment (SMA) capabilities to prioritize the safety of patients with diabetes and obesity and to enhance patient and provider comfort via virtual healthcare.

The Challenge

 

Cleveland Clinic needed to ensure patient and provider safety and continuity of care for patients with diabetes at high risk for COVID-19 within the Endocrinology and Metabolism Institute (EMI).

The Approach

 

Outpatient visits: telemedicine + SMA

  • Offered to 80% of patients age 60+ with HbA1c levels >9% seen in the past year and who needed a follow-up visit

Inpatient visits: virtual alternatives

  • Offered to patients hospitalized for non-COVID-19 related illnesses
    • –

      Virtual F2F visits

    • –

      Phone consults with the patient, facilitated by hospital staff

    • –

      Peer-to-peer e-consult without the patient

Outcomes

 

Within days

  • Converted to virtual visits using existing technology and methods
  • Minimized unnecessary contact, spread of infection, and use of PPE

Within ~6 weeks

  • 90% of patient visits and 100% of SMAs were virtual
  • Increased provider confidence in telemedicine to effectively manage chronic disease
  • Increased patient satisfaction with the convenience and safety of virtual visits
  • Shorter virtual visits and the ability to work from home gave staff better quality of life

For more information, visit Cleveland Clinic

 

PPE=personal protective equipment; T2D=type 2 diabetes.

 

Endocrinologists convert to telemedicine virtually overnight during COVID-19 pandemic. Cleveland Clinic Website. https://consultqd.clevelandclinic.org/endocrinologists-convert-to-telemedicine-virtually-overnight-during-covid-19-pandemic/. Published April 22, 2020. Accessed August 21, 2020.

OPTIMIZING TRANSITIONS OF CARE

Vidant Medical Center: Implementing a New Model of Interdisciplinary Transitions of Care

Overview

 

Vidant Medical Center, a large tertiary health system in North Carolina, improved transitions of care and provided education and resources to better care for a population of patients with diabetes that was ~25% higher than the national average.

The Challenge

 

Vidant Medical Center needed to deliver coordinated care to meet the specific needs of patients with diabetes and their families while reducing the total cost of care.

The Approach

 

Vidant Medical Center utilized the ABC approach:

  • Assessed the current model against existing practices
    • –

      Only 20% of patients with diabetes discharged each month were contacted by a care team

    • –

      Only 1 received an education session

  • Built a model based on multidisciplinary team input
  • Created an interdisciplinary diabetes care model

Outcomes

 

The new model yielded:

  • ~$425,000 in annual cost savings
  • A 53% diabetes program budget reduction

For more information, visit Diabetes Spectrum

 

Hardee SG, et al. Interdisciplinary diabetes care: a new model for inpatient diabetes education. Diabetes Spectr. 2015;28:276-82.