PARTNERS FOR IMPROVING PATIENT HEALTH

DAYTON­—Columbia County Health Systems (CCHS) is proud to announce a new program for 2022 called Partners Improving Patient Health (PIPH). This program came out of a multi-year grant awarded to CCHS by the U.S. Health Resources and Services Administration (HRSA) to help evolve the way we care for patients with chronic obstructive pulmonary disease (COPD), congestive health failure (CHF), and cardiovascular disease (CVD), including difficult to control hypertension (high blood pressure, HTN) and those who have had myocardial infarctions (heart attacks, MI).

Our community partners in this program include Elk Drug, Aging and Long-Term Care, WA Dept of Health, DSHS, Hospice of Walla Walla and more. The first year of this grant allows for a planning phase. Currently, we are holding weekly meetings involving CCHS and Clinics administration and a variety of CCHS staff from analytics specialists to nurses and providers. We are working with our Health Resources and Services Administration (HRSA) contacts to help us with various grant requirements and reports. The initial process of putting together our list of patients that qualify for the three arms of the program is time-consuming in itself.

Currently, we are developing our list of possible participants, writing policies, printing education tools to help participants manage their disease, and doing research to make sure we are using the most current standards of care. The educational tools will be aimed at increasing participants’ knowledge of their disease, and since knowledge is power, ultimately empowering patients in self-care activities such as using their ‘as needed’ medications, familiarizing them with the medications they take, understanding what to do when things get worse, knowing what symptoms they should report to their Health Care Provider and which situations do require a higher level of care such as the Emergency Department (ED). We will seek to provide education programs for each disease and plan to use 1-on-1 home teaching and group opportunities. These group programs will include education, community partners, and contact with a pharmacist, respiratory therapist, Physical or Occupational therapists who can offer additional knowledge to our participants.

A primary goal, and one of the purposes of the grant program, is preventing ED visits and hospitalizations. This decreases the cost of care for the patient and, more importantly, shows we are developing a better way of providing care by preventing sudden disease symptoms. Another core goal is to decrease disease stress on patients and their families. Future goals include meeting our participants at the time of their discharge from the hospital to help them understand their hospital care, disease changes, and medication changes. Research shows that working with patients to understand these changes can prevent hospital readmission, which is a common and costly event for patients in health care today. We also hope to begin contacting participants who have ED visits related to the diseases this program is focusing on, which may require changes to the participants’ current plan of care. There is simply not enough time in clinic appointments to cover all these important things and spend enough time to help patients truly understand their chronic disease and its care and treatment. The PIPH program seeks to both address those time constraints and offer opportunities to care for our patients more thoroughly. We are excited to extend this program to our patients as a new model of care instead of the old ‘fee for service’ that we have now.