Pittsburgh Regional Health Initiative project designed to reduce hospital readmissions

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Butler Health System is holding an open house from 4 to 6 p.m. today for its new Primary Care Resource Center, one of six centers opening at area hospitals in the next two months as part of a Pittsburgh Regional Health Initiative project designed to reduce hospital readmissions.

The target audience is patients at highest risk of readmission, such as heart attack victims or those diagnosed with heart failure or chronic obstructive pulmonary disease.

"These diseases very typically have co-morbidities. None of these diseases occur by themselves," said Keith Kanel, the health initiative's chief medical officer and principal investigator for the Primary Care Resource Center Project. They are also complicated diseases, he added, "where any misstep with diet, or forgetting meds, or the cost of the medications, or an ozone alert day" can trigger an emergency hospital visit.

"Our goal is to keep people healthy."

Although the Butler center is located at the hospital, its work is more educational than clinical.

The center's team -- consisting of three nurse care managers and a pharmacist, as well as nutritionists, behavioral health and other professionals -- meets with patients during the hospital stay.

Following discharge, the staff follows up with a home visit and patients are then encouraged to come to the center where they can meet with staff for help managing their conditions.

"When you are in the hospital, it is a stressful time and it is confusing," said center director Erin Stewart. "You may have a new diagnosis, and we've found that patients need that follow up. And it's beneficial for them to know they have the support."

The Pittsburgh Regional Health Initiative project is funded by a three-year, $10.4 million grant from the federal Center for Medicare and Medicaid Services.

Besides Butler, the centers will be operating at Uniontown Hospital in Fayette County; Sharon Regional Health System in Mercer County; Conemaugh Health System in Johnstown, Cambria County; Indiana Regional Medical Center, Indiana County; and Wheeling Hospital in Wheeling, W.Va.

The idea is that by reducing the number of readmissions, patients will be healthier and health care costs will be lowered. A pilot project at Monongahela Valley Hospital, Washington County, last year resulted in a 47 percent decrease in readmissions.

"The PCRC has been so successful because it's so well structured," said Donna Ramusivich, Mon Valley's senior vice president for compliance, quality, utilization and safety. "Our care managers and pharmacist work with patients from the time they are admitted until they're discharged and then we continue working with them at home."

Since April, the Mon Valley center also started working with congestive heart failure patients, she said, and readmissions "have dropped from 25 percent to 11.5 percent, which is significant."

Butler's center saw its first patients Aug. 1, so it's too early to tell what its results will be. Ms. Stewart said, "Patients have told us, 'I feel like I understand my disease better than I ever have.' "

In assessing the program's success, said Dr. Kanel, "We think it's the human interaction, the fact that the nurses and pharmacist make themselves available to each patient."

Now that Medicare is penalizing hospitals for higher-than-expected readmissions, hospitals have added financial incentive to prevent return visits, so everyone benefits -- patients who can continue their daily lives, providers who help their community stay healthy and insurers who see more cost-effective care.

Said Dr. Kanel: "It's hard to find anything that's not good about this."

businessnews - health

Steve Twedt: stwedt@post-gazette.com or 412-263-1963.


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