Kyle Allen has been trying to bridge the communication gap between Summa Health System, Akron, Ohio, and skilled-nursing facilities for years.
His most recent attempt helped create the Care Coordination Network, a year-and-a-half-long effort involving 27 skilled-nursing facilities that meet regularly to discuss the patient transfer process and ways to improve patient care. All of the 39 facilities in Ohio's Summit County-which is where Summa's three hospitals are located-were invited to take part.
There is no financial obligation and Summa doesn't take over any operational control of the facilities. Neither Summa nor the facilities put up money to start the network, but they signed an agreement to meet monthly. In order to join the network, facilities must sign a memorandum of understanding with Summa in which they pledge to admit patients seven days a week and have a representative attend at least 90% of the network's meetings. Those meetings are the only time the network's participants formally meet with Summa.
Allen, Summa's chief of geriatric medicine and medical director of Summa Senior Health Services, which helps patients and their families when they are considering moving into a skilled-nursing facility, said the network has helped Summa's hospitals streamline patient transfers between hospitals and skilled-nursing facilities and troubleshoot potential problems, including overcrowding.
Patients often spend an extra day in the hospital because their families are trying to decide which facility to choose, Allen said. When patients stay longer, it costs the hospitals bed space and money.
During some of the network's monthly meetings, the facilities realized this was a problem for the hospitals. In an effort to speed up the decisionmaking process for families, representatives wrote profiles of their facilities. When families are deciding where to place their loved ones, they can flip through a notebook of profiles of the skilled-nursing facilities in the network. Allen said he hopes to eventually replace the notebooks with DVDs so families can take virtual tours of the facilities.
Just being included in the notebook is beneficial for facilities because it gives them more publicity. Patients still can be transferred from a Summa hospital to a non-network facility, but non-network facilities won't be listed in the book, said Judy Akins, executive director of Summa Senior Health Services.
Along with overcrowding, Summa hopes to reduce readmission rates to its hospitals from skilled-nursing facilities. Patients often are admitted to a hospital when they would be better served at a skilled-nursing facility, Allen said. An example of this occurred recently when a patient was transferred from a Summa hospital to a skilled-nursing facility but couldn't be admitted because the facility didn't have the necessary equipment to care for the patient. The patient had to be readmitted to the hospital.
So far, it's too early to tell if the network has helped reduce lengths of stay or has cut down readmission rates, said Akins, who runs the network's monthly meetings. But at least the network has helped break the "wall of silence" between the Summa hospitals and the skilled-nursing facilities, Allen said. That silence often led to wasted time and money.
"Patients would come in for a procedure and there would be no guardian," Allen said. "So then we would have to cancel the procedure."
To avoid this type of problem, the network established a new patient-transfer form. Some of the skilled-nursing facilities allow patients to fill out the standard form electronically on the Internet. Each of the facilities that participate paid $500 to acquire the computer service and pay $150 per month to keep it running.
Scott Bower, administrator of Cuyahoga Falls (Ohio) Country Place, a facility within the network, decided to invest in the Internet system. He said it allows his facility to contact the hospitals faster and make quicker decisions about whether a patient would be a good fit for his facility.
"If it helps us admit one more patient a month, it's worth (the money)," Bower said. "It pays for itself."
Summa set up the initial network meeting and invited all of the skilled-nursing facilities in the county to attend. At first, it was difficult to get facilities to cooperate, Akins said. Bower said this was probably because the facilities weren't used to sharing their business operations with competitors.
"In this business not everybody wants to share their secrets," he said. "But once we started talking we realized that everybody was having the same problems."