Latest / Becker’s Healthcare Podcast / Driving Healthcare Home: How to Create Capacity by Streamlining Bottlenecks, Improving Throughput, Shortening Length of Stay, and Reducing Readmissions

Transcript

Driving Healthcare Home: How to Create Capacity by Streamlining Bottlenecks, Improving Throughput, Shortening Length of Stay, and Reducing Readmissions · Becker’s Healthcare Podcast

• 0:00
  Hi everyone. This is Chanel Banger with Becker's
• 0:02
  Healthcare. Thank you so much for tuning in
• 0:04
  to the Becker's Healthcare podcast series. In today's
• 0:06
  discussion, we're gonna talk about driving healthcare home.
• 0:09
  How to create capacity by streamlining bottlenecks,
• 0:12
  improving throughput, shortening length of stay, and reducing
• 0:16
  readmissions.
• 0:17
  Joining me for today's discussion is Deidre Rowley,
• 0:20
  the senior director of clinical partnerships and growth
• 0:22
  at MyLaurel. Deidre, thank you so much for
• 0:24
  joining me today. Thanks for having me. It's
• 0:26
  a pleasure.
• 0:27
  Perfect. Well, to get us started out, can
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  you give us a quick overview of your
• 0:30
  career in health care, including your current role
• 0:32
  in organization?
• 0:33
  Absolutely. So I'm an ER nurse by background.
• 0:37
  Spent many years at the bedside before going
• 0:39
  into leadership roles at an academic medical center.
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  I was part of a team that stood
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  up a hospital at home program for my
• 0:47
  organization,
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  post pandemic or in the midst of the
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  pandemic,
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  and really
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  got very intimate with
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  the thoughts that patients can actually be taken
• 0:57
  care of in the comfort of their own
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  home.
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  I moved into more of a corporate setting,
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  joining an RPM company
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  as a consultant
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  as more and more organizations were starting to
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  stand up hospital at home programs. So
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  I was helping
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  not only
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  the original initiatives, but also working with hospital
• 1:17
  at home programs that were stagnant in growth
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  and helping them expand.
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  I joined my Laurel just about two months
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  ago,
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  as the senior director of clinical partnerships and
• 1:27
  growth
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  because I really noted that
• 1:31
  there's
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  a gap between
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  inpatient
• 1:34
  hospital at home
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  and post discharge. And MyLaurel's model
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  really does a wrap around for their patients,
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  and I love their mission that they're solving
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  for that black hole of what happens to
• 1:48
  patients after they leave the hospital.
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  Got it. Got it. And now that we
• 1:51
  have a sense of your background, we'll get
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  into the meat of the podcast a bit.
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  Many patients are facing a repetitive cycle of
• 1:57
  ED usage. This leads to increasing borders, throughput,
• 2:01
  etcetera. In this scenario, how is the patient
• 2:04
  journey different with care at home?
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  Yeah. So MyLaurel
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  is actually offering,
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  like, a third option for patients.
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  If you think about the difficulty of finding
• 2:15
  primary care physicians in today's climate,
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  patients are using emergency departments, not only as
• 2:21
  primary care, but also for chronic disease management.
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  So as we look ahead, myLoral,
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  like I said, is is just another option
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  for clinicians
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  to think about,
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  does this patient need to be admitted to
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  an inpatient unit?
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  Does this patient go home without services? Or
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  is there a line where a patient can
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  go home,
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  be taken care of in an acute way,
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  and
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  have support in the home post discharge?
• 2:50
  That sounds amazing. And can you talk about
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  MyLaurel's approach to this?
• 2:54
  Sure. So MyLaurel's really working with organizations to
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  think about
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  what are their low to mid acuity patients
• 3:02
  that are being admitted to the hospital.
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  It may be for social reasons. It may
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  be
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  for
• 3:09
  a couple of days of IV antibiotics.
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  But, truly,
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  are they needing the resources
• 3:16
  of a true hospital inpatient stay?
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  MyLoral
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  has the opportunity
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  to continue the care plan
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  as the patient is discharged. So what we
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  do is we
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  take a discharged patient from either an ED
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  or a traditional inpatient unit,
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  and we are continuing their acute care at
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  home, but then also offering a fourteen day
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  episode
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  where we're doing a whole wrap around service.
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  So making sure that they're going into primary
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  care, following up with specialists as needed. So
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  really
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  making sure that they're on a path or
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  a trajectory
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  to actually have success and not represent to
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  an emergency department.
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  And I think that the value of that
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  is that
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  with our ability
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  to reduce the patient's length of stay, either
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  taking them out two days early
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  from an inpatient
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  bed or from an emergency
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  department's ops unit,
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  you're able to streamline the patients that really
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  need to be in a higher acuity setting
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  such as an ICU or
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  an inpatient unit. So
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  you're not seeing the border population sitting in
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  areas
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  of the hospital,
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  even PACU or EDs or ops units. So
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  really making it more streamlined, like I said,
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  And thinking more if you go a level
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  deeper is we're actually contributing to
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  80 wait times in the waiting room or
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  or left without being seen percentages
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  just by opening beds for the throughput.
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  That's amazing to hear. And now that we
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  know the approach that MyLaurel takes, what are
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  the benefits that health systems can realize with
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  the strategy? And do you have any specific
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  case studies or improvement metrics that you can
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  share?
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  Sure. I think that the majority of health
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  care systems across the nation are really in
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  a bed crunch.
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  It's really, really expensive to build new buildings,
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  to recruit staff.
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  And if you think about
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  how
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  MyLaurel is helping
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  organizations
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  solve for that throughput,
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  there's been a lot of benefits.
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  When you're thinking about
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  the strategy,
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  some of our partners are reporting that
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  sending patients home with MyLaurel, they're actually seeing
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  that
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  they are able to have a capacity generation
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  of up to 15 beds per day in
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  each facility.
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  Their readmission rates
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  for their highest cohorts
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  has shown a 60% reduction. So those high
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  risk patients that are utilizing that ED
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  as primary care or continue to come back
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  because they're not improving post discharge.
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  We're also seeing that there's a nine to
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  one ROI that organizations
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  have reported. Some of our partners are reporting
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  anywhere from five to 9%
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  return of investment
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  because they're able to backfill
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  beds with higher acuity patients.
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  So it's threefold. You're not only addressing your
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  capacity issues,
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  you're addressing
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  your staff burnout, and then you're also addressing
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  what's best for the patient, which I think
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  is the most important thing.
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  Absolutely.
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  And now moving forward, traditionally, hospital at home
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  has been a daunting initiative with a Rocky
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  Path. How is the myLaurel model of care
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  different than that? You know, it's like I
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  said, I spent a lot of time in
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  that hospital at home space, and I think
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  that it is definitely
• 6:48
  for some patients, but it there's some resource
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  constraints, and CMS
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  has some very stringent,
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  I'll call them rules to follow.
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  My role is an outpatient
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  model.
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  And thinking about your lower acuity patients that
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  may be a soft admit or an observation
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  patient may never even be eligible for hospital
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  at home, we're able to scale very fast.
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  We're able
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  to take more patients out of the four
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  walls than your traditional hospital at home program
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  because, like, they have staff constraints. You know?
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  Is if you think about
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  they need to be in the home two
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  two times a day. The waiver has very
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  specific
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  guidelines,
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  and
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  it's based on
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  a DRG. So you're bringing your patients home.
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  The typical state is three to five days
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  similar to a traditional inpatient.
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  Where MyLaura, we do an episodic
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  visit. We actually are taking these patients out,
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  giving acute care in the home, but then
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  following them for fourteen days.
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  So by not only opening up bed capacity,
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  we are ensuring that they're not following into
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  a black hole post discharge. We're tying them
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  back to a primary care physician and checking
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  to make sure that they've done those visits,
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  making sure that they have their resources,
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  their rides. There's a big case management component
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  of the MyLaurel solution
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  that I think that is not only beneficial
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  to the patient, but also to the health
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  system.
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  I love that. And now as you look
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  ahead, what's exciting you most in the care
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  at home space?
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  I think that we need to meet the
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  patients
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  where they are and
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  understand
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  what is going
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  on around them.
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  The care at home space is very different
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  than it was years ago. You can safely
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  deliver acute care in the home
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  while getting a sense of what are the
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  needs of the patient, what is
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  driving them back to the health care system
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  for emergency room visits.
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  And, really,
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  what's exciting to me is that
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  patients love it. Our NPS scores are above
• 8:58
  97%,
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  which actually then contributes to your hospital HCAHPS
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  scores because they think that this is just
• 9:05
  a smooth transition that this organization is holding
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  my hand and giving me a little bit
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  of a concierge medicine type experience. And I
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  I think that that's really great.
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  That's amazing to hear. Well, Deidre, I wanna
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  thank you for your time today. But before
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  I let you go, is there anything else
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  that listeners should know?
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  I really love the MyLaurel
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  care model.
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  And I think what's amazing is that our
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  company trusts and has confidence on what we
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  have built with organizations,
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  and
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  we actually guarantee our services. So if a
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  patient returns
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  to the hospital within their episodic care, we
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  actually are going at risk because we
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  are so confident
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  that we're doing what's best for the patient.
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  And I don't think that you get that
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  from a lot of other models.
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  So we take risk, and the hospital's not
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  owning not owning the risk.
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  Love that. Well, Deidre, I wanna thank you
• 10:02
  once again for your time and insights today.
• 10:04
  We also wanna thank our podcast sponsor, MyLaurel.
• 10:07
  You can tune in to more podcasts from
• 10:09
  Becker's Healthcare by visiting the podcast page at
• 10:11
  beckershospitalreview.com.
• 10:14
  Thanks,