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College Students Help Cut Readmissions in Half
It could be said that there are three sides to every hospital admission (and readmission) — what’s observed in the inpatient setting, what the patient says, and what’s really going on in the patient’s home.
AlexSandra Davis, RN, BSN, recently experienced this when a patient was referred to Wooster (Ohio) Community Hospital’s Community Care Network (CCN), a program that trains and uses college students as community health workers. Both the patient and her case manager said she was safe to go home, but when Davis, who manages Wooster’s CCN, got to the woman’s residence she saw the third side of the story.
“I got in the home and she didn’t have her medication; she didn’t have her breathing treatments; she didn’t have a nebulizer; she didn’t have a glucometer to check her blood sugar,” Davis told HealthLeaders Media.
If left unchecked, those issues could have led to a hospital readmission. Wooster’s CCN, a partnership between the hospital and the College of Wooster, was launched in 2013 to prevent that kind of situation.
Davis and her counterpart at the college, Carol Sedgwick, developed the CCN with the help of Barry Bittman, MD, who was using college students as community health workers in Meadville, Pennsylvania. Sedgwick oversaw specifics on the college’s end, such as course- registration logistics, and Davis developed the course’s clinical components.
Students, usually sophomores at the liberal arts college, start with a general overview of the program, including a description of the role and responsibilities of a health coach. Davis then covers the clinical aspects, including pathophysiology, of the various diseases students may encounter out in the field, such as diabetes, chronic obstructive pulmonary disease, heart failure, and hypertension.
Students review disease-specific booklets that all Wooster patients receive on discharge. They help patients set goals, ensure that patients have the proper resources to maintain or improve their health, and report any issues to the patients’ primary health care providers.
Each student is assigned two patients, whom they visit once a week. The program awards students 0.5 credit hours toward fulfilment of the college’s volunteer service requirement.
Currently, 35 students and 80 patients are enrolled, Davis said, and by January 2016 she expects more than 100 patients to be part of the program. As enrollment has gone up, hospital use has gone down. According to data collected a year ago, patients enrolled in the program had a 26% reduction in emergency department use and a 51% reduction in hospital readmissions.
Loraine Frank-Lightfoot, RN, DNP, former chief nursing officer at Wooster, said that while the CCN is definitely of value, those wishing to start a similar program should consider a few factors. First, consider funding. Wooster’s program is free to patients, but the program has never been supported by grant money.
“The grants either pigeon-hole you too much, or the grant is over and you don’t have any money to fund it,” Frank-Lightfoot explained. “We made the commitment when we started that we were going to do the funding through the hospital. That way we had control; we could partner with whom we needed to partner with; and we knew the money wasn’t going to dry up after a year.”
According to Davis, one way to keep costs in check is to be savvy about staffing. Volunteers aside, the program’s staff consists of only Davis, one full-time licensed practical nurse (LPN), and one part-time LPN.
Understanding the community’s needs and resources is also key to developing a productive program, Frank-Lightfoot added. “Be open to doing this in a nontraditional way,” she said. “You have to find what works in your community and tailor it with the resources you have available. You may not be able to find a college or university that’s willing to partner. You may have to pay people to do it.”
Source: HealthLeaders Media; September 1, 2015.