Charleston Area Medical Center (CAMC), a 956-bed academic medical center in Charleston, West Virginia, has been able to leverage interactive patient engagement and education technology to improve patient outcomes—specifically to reduce readmissions for causes related to chronic illnesses. The four-hospital system in West Virginia reversed a trend of rising readmissions. CAMC leaders have reduced their readmissions for congestive heart failure (CHF) by more than 22 percent, and for chronic obstructive pulmonary disease (COPD) by almost 30 percent in early 2016 compared to the previous year. Readmissions have also been reduced for pneumonia. CAMC has one of the largest heart programs in the U.S., and the only kidney transplant center in West Virginia, according to hospital executives.
In this initiative, the CAMC leaders have partnered with this success is a comprehensive strategy supported by the TIGR interactive patient engagement and education system from the Raleigh, N.C.-based TeleHealth Services.
Recently, Beverly Thornton, R.N., education division director in the Education and Research Institute at Charleston Area Medical Center, spoke with Healthcare Informatics Editor-in-Chief Mark Hagland, regarding this patient education and patient engagement initiative. Below are excerpts from that interview.
How long have you been in your current position?
I’ve been a nurse for a number of years, but I have a love and appreciation for patient and family education. That’s what drew me into this area. And so I am an advocate for this. I landed in the Education and Research Institute, working with patients and community health activities, and also with our continuing education staff and medical professionals. I’ve been doing this portion since 1995; I’ve been in nursing for 42 years.
How big a staff do you have at the Education and Research Institute?
We have a continuing education department for CME, and I have two people who do that. And I have a media department and TV studio, and graphic designers and TV producers and those kinds of folks; so that’s about four or five staff members altogether; but they all have a wide variety of responsibilities, including running our learning management system for employees’ routine and required education for working in the hospital. Altogether, about a dozen people have some involvement in our continuing education, learning and management, processes. And we do education and training around the EMR as well.
And who on the team focuses on patient and family education?
That would be me. We don’t have a department, per se; we have a multidisciplinary council. Patient and family education is everyone and everywhere—it’s the responsibility of all the clinicians and everyone who touches the patient and family. We have a multidisciplinary council from all four hospitals and from all disciplines that I chair, to develop policies and procedures. There are about 35 on the council. We meet once a month. We also have ad hoc members; a lot of our physician membership is ad hoc; we will bring physicians in to speak on specific topics; it’s a two-hour meeting every month, and some online meetings as well.
How would you articulate your overall approach or strategy towards patient and family education?
I would say it’s around patient and family engagement around that education process. We can just be giving them things and hold them accountable for behavioral change. It’s a cultural thing, too, in our Appalachian state; it’s very cultural. So we have to engage the primary care provider, because our folks still listen to their primary care providers, they do what they tell them to do. So we have to engage them as a component to their care process.
And all of this is particularly important in the context of the low health status of the population, poverty and unemployment, in West Virginia, correct?
Yes, and there are additional social factors, too, including the aging of the population, and smoking.
What are the biggest gaps or areas you work on?
Access to follow-up care, making sure that that happens; and that they have the ability to get there; that they have the resources, so for example, a set of scales in their house to weigh themselves, with CHF, as well as to medications, and those kinds of things; and then the medication compliance issue. I don’t think it’s anything new or that anyone else isn’t experiencing. And then it’s the general engagement, so that they are central to making the difference—getting them to realize that they can make a difference in the outcome of their health by making lifestyle changes.
How did you achieve those strong readmission reductions for CHF and COPD in a year?