Inpatient beds at the seven-hospital system are often packed with patients readmitted to the facility because they have trouble receiving ongoing treatment for their mental health conditions. These patients are usually homeless, said Mary Brainerd, the system's CEO.
To address the problem, HealthPartners recently partnered with Catholic Charities to create living centers for mentally ill homeless patients. The facilities are staffed with nurses who help ensure patients follow their care plans.
“We've worked really hard to integrate our mental healthcare services into community resources,” said Dr. Brian Rank, co-executive medical director of HealthPartners.
Even with the investments by HealthPartners to help mentally ill patients, Brainerd said there still aren't enough beds or clinicians to meet the demand. “I think the whole system for mental healthcare-at least in our region-is still deeply flawed. And every day we have reason to wish we could do it differently,” she added.
Brainerd said the leadership sees its physicians as a critical resource to tackle the many complex issues the system faces in its communities. For example, physicians came up with a plan in 2014 to decrease opioids prescribed across the system's care sites after patient data showed high rates of prescribing.
Changes were made regarding who received opioid prescriptions and how frequently. As a result, the number of patients prescribed opioids decreased 17.4% from February 2015 to February 2017.
“We recognized that we could have done better,” Rank said.
Maury Regional Health, recognized by Truven for the fourth time this year in the small-system category, has fostered a culture that “constantly pursues excellence,” said Alan Watson, CEO of the three-hospital organization based in Columbia, Tenn.
Physicians compare readmissions rates and lengths of stay at the system to the best hospitals in the country. Doctors also participate on advisory boards to discuss areas in need of extra attention, Watson said.
Patients are even called on to help set goals for the organization. When Maury Regional built a new critical-access unit in 2016, patients and their families were involved in the process throughout a two-year period. As a result of their feedback, the unit has a designated area for family to sit and relax as well as a pantry so food and snacks can be stored. The unit has open visitation hours so family members can see a loved one at any time.
Patient-satisfaction scores have steadily improved over the past four years since Maury Regional has made it a goal to help patients “feel more at home,” Watson said.
At Albuquerque-based Lovelace Health System, a second-time winner in the small-system category, daily meetings with executive leaders across the system are conducted to discuss issues big or small. “The point of the meetings is not to punish but to talk about how we can do better,” said Dr. Gregory Nelcamp, chief medical director of the six-hospital system.
The concerns brought up at those meetings are then filtered down to frontline staff during daily huddles so they can be aware of the challenges and look for solutions.
Access to data is a key way for staff to create and monitor their initiatives. But it is only helpful when data it are available in real time. “Looking at data that is very old is like driving looking through a rear-view mirror,” Nelcamp said. The system is now in the process of implementing a new EHR system from Epic, which Nelcamp said will help advance Lovelace's goals.
Physicians and nurses are inspired to come up with initiatives to improve care because they know their ideas will be heard and tried, Nelcamp said.
“We have made tremendous strides and as our culture keeps maturing, quality has become not what we do but who we are,” Nelcamp added.