Md.’s CARE act helps care­givers and pa­tients

Baltimore Sun - - COMMENTARY - By Carmela Coyle and Hank Green­berg Carmela Coyle (ccoyle@mhaon­line.org) is pres­i­dent and CEO of the Mary­land Hospi­tal As­so­ci­a­tion; Hank Green­berg (hgreen­berg@aarp.org) is state di­rec­tor of AARP Mary­land.

Re­cov­ery from ill­nesses fol­low­ing hospi­tal care varies in du­ra­tion, but one thing is cer­tain: Mak­ing sure that pa­tients re­ceive the right care af­ter they leave the hospi­tal has a dra­matic im­pact on a pa­tient’s well-being, prog­no­sis and out­come, and it is a ma­jor in­gre­di­ent in Mary­land’s trans­for­ma­tion of health care.

The peo­ple who work in hos­pi­tals have al­ways known this, but it was re­cently quan­ti­fied in an Agency for Health­care Re­search and Qual­ity study that found that pa­tients who have a clear un­der­stand­ing of their af­ter-hospi­tal care in­struc­tions, in­clud­ing how to take their medicines and when to make fol­low-up ap­point­ments, are 30 per­cent less likely to be read­mit­ted or visit the emer­gency depart­ment than pa­tients who lack this in­for­ma­tion.

While pro­vid­ing this care can be re­ward­ing and joy­ful as a loved one re­cov­ers, it can also be lonely and frus­trat­ing; most fam­ily care­givers per­form this critical role with no med­i­cal train­ing. To help, AARP Mary­land and Mary­land’s hos­pi­tals, dur­ing the state Gen­eral As­sem­bly’s leg­isla­tive ses­sion ear­lier this year, worked to­gether to push for the pas­sage of the Care­giver Ad­vise, Record, En­able (CARE) Act. It helps hos­pi­tals work with fam­ily care­givers to co­or­di­nate care for a pa­tient, which can in­clude med­i­ca­tion man­age­ment, wound care, di­etary man­age­ment and the op­er­a­tion of spe­cial­ized med­i­cal equip­ment. Mary­land is one of 30 states, plus Wash­ing­ton, D.C., Puerto Rico and the U.S. Vir­gin Is­lands, to pass the law, which in our state be­came ef­fec­tive Satur­day. It fea­tures three very im­por­tant pro­vi­sions:

The name of the fam­ily care­giver is recorded by the hospi­tal when a loved one is ad­mit­ted;

The fam­ily care­giver is no­ti­fied when the loved one is to be dis­charged to an­other fa­cil­ity or back home;

And the hospi­tal must pro­vide an ex­pla­na­tion and in-per­son in­struc­tion of the med­i­cal tasks their loved one will re­quire, such as med­i­ca­tion man­age­ment, in­jec­tions, wound care and trans­fers that the fam­ily care­giver will per­form at home.

What does the CARE Act mean for Mary­lan­ders? It means bet­ter, more co­or­di­nated care that will make it eas­ier for pa­tients, care­givers and hos­pi­tals to work to­gether to ease the road to re­cov­ery for those who have suf­fered ill­ness or in­jury, to give them the best op­por­tu­nity to get bet­ter quickly and with min­i­mal com­pli­ca­tions. AARP of­fers tools for care­givers on­line at its Care­giver Re­source Cen­ter.

The CARE Act is just one way that hos­pi­tals are work­ing with com­mu­nity part­ners, like AARP, to make sure that Mary­lan­ders re­ceive the best care pos­si­ble. Hos­pi­tals are reach­ing out into their com­mu­ni­ties like never be­fore. In­stead of episodic care, where pa­tients are treated for what­ever ail­ment they may have at that given mo­ment, hos­pi­tals are pur­su­ing “whole-per­son” care, where they ex­am­ine all of a per­son’s needs — phys­i­cal, psy­cho­log­i­cal, en­vi­ron­men­tal and more.

LifeBridge Health, for ex­am­ple, has started a pi­lot pro­gram, the Mary­land Faith Health Net­work, which con­nects hos­pi­tals with churches, syn­a­gogues, tem­ples and other faith or­ga­ni­za­tions to im­prove their con­gre­gants’ well-being.

Car­roll Hospi­tal Cen­ter has be­gun Care Con­nect, a free pro­gram that con­nects peo­ple who have com­plex health is­sues with a health navigator — a reg­is­tered nurse or li­censed so­cial worker who pro­vides one-onone guid­ance and care co­or­di­na­tion.

Wash­ing­ton Ad­ven­tist Hospi­tal launched See You in 7, a pro­gram to en­sure that all pa­tients have a fol­low-up ap­point­ment with their pri­mary care provider within seven days of dis­charge.

Johns Hop­kins Bayview Med­i­cal Cen­ter has “Care A Van,” an RV with a so­cial worker and med­i­cal staff who pro­vide free health screen­ings, help with Med­i­caid ap­pli­ca­tions, and pro­vide im­mu­niza­tions and more for unin­sured chil­dren and their fam­i­lies with no reg­u­lar source of med­i­cal care.

And At­lantic Gen­eral Hospi­tal pro­vides bed­side “first fill” med­i­ca­tion de­liv­ery and phar­ma­cist con­sul­ta­tions just prior to a pa­tient’s dis­charge, to make sure they go home with the medicine they need.

These are just the tip of the ice­berg when it comes to new ways that com­mu­nity or­ga­ni­za­tions, like Mary­land’s hos­pi­tals and AARP Mary­land, are join­ing forces to make health care bet­ter, more ac­ces­si­ble, and more ef­fi­cient.

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