Newsletter articles, 2018 (please contact for additional):

Miracle Nurse: Jeanine Rapp, RN

After a Miraculous Recovery, A New Nurse Begins Work at the Hospital That Saved Her Life 

On Sept. 17, 2017, Jeanine Rapp was brought into the emergency room (ER) at AMITA Health Adventist Medical Center La Grange after experiencing difficulty breathing. She was in her last semester of nursing school and had been sick for a few weeks with an upper respiratory infection. Within four minutes of arriving to the ER, she was in full cardiac arrest due to a saddle pulmonary embolism. A blood clot in her right leg had moved to her lungs; her chances of survival were slim.

Placed under the care of Amit Bakshi, MD, emergency medicine, and Barry Sidorow, MD, FACC, cardiology, Jeanine underwent an echocardiogram, was immediately started on medication to break up the blood clot and received CPR. After 90 minutes of resuscitation, her blood pressure still was only 30. Her family was told that the outlook was grim. Though unresponsive, her boyfriend asked her to hold on for just a while longer so that her daughters could have the chance to say goodbye. In the time between her partner retrieving her daughters from the waiting room and returning with them to her room, Jeanine’s blood pressure had risen to 150. Her care team was speechless, unable to explain what had just happened. It was nothing short of a miracle.

Her recovery would not be easy. During her time in the hospital, Jeanine had to have 11 blood transfusions and nine dialysis treatments, with the first treatment being more than 12 hours long. Her kidneys had shut down during the resuscitation and there was initial concern that she might not make it through the first dialysis treatment.

Despite a difficult recovery, by mid-October she was back home, and with the support of her family she was back to nursing school in January. “The team at AMTA Health La Grange saved my life. The doctors, the nurses in the ICU—everybody in the hospital was amazing. I can’t even begin to thank half the people who cared for me. One day I was the sickest person there and the next day I was the ‘miracle woman.’ Most people don’t survive what I went through,” Jeanine says.

Exactly one year later—Sept. 17, 2018—she arrived at AMITA Health La Grange for her first shift as a registered nurse in the progressive care unit. “I have such a compassion for my patients. When taking care of critical patients, I now can say, ‘I know what you’re going through, I’ve been there.’ I can’t begin to describe how blessed I feel to be working in the hospital where I was treated, to give back and care for my patients in the same way I was cared for one year ago. Every day I get to see the familiar faces of the doctors and nurses who helped to save my life.

“AMITA Health La Grange always has been my community hospital. The faith-based setting provides a warm, welcoming and comforting environment. I arrive for every shift happy to be here. Walking into the hospital is like walking into my home. I’m exactly where I need to be. This whole experience has taught me what really matters in life.”

Thank you, Jeanine, for sharing your story and for your continued dedication to our mission and the compassionate care you provide.

 

Leading the Way: The Diamond Headache Unit at Presence Saint Joseph Hospital-Chicago

Established in Chicago in 1972, the Diamond Headache Clinic was the first comprehensive private headache clinic in the world to offer specialized care for those suffering from chronic headache pain. As a continuation of this care, in 1981, the Diamond Headache Unit was founded, becoming the nation’s first dedicated inpatient unit for headache treatment.

Today, the 43-bed inpatient unit, located at Presence Saint Joseph Hospital-Chicago, offers a comprehensive, interdisciplinary approach to headache diagnosis, treatment and management by a multidisciplinary team of physicians, nurses, psychologists, pharmacists, dietitians, physical therapists, recreational therapists and counselors. Led by Merle Diamond, MD, managing director, the Diamond Headache treatment team is nationally and internationally recognized for its specialized expertise in the care and treatment of severe and chronic headache disorders. The unit’s patient-centered treatments range from individualized drug therapy and psychological intervention to alternative therapies, such as massage therapy and acupuncture, to non-drug therapies including biofeedback training. The inpatient unit even offers lighting and temperature controls to maximize the patient experience. The patient’s family members are encouraged to be part of the patient’s treatment program.

“The inpatient Diamond Headache Unit is a state-of-the-art facility designed to treat patients who have been battling chronic headaches and migraine for a period of time,” says Mark Greco, PT, DPT, clinical program manager. “Our care team takes an individualized approach to each patient, integrating multiple disciplines to maximize the patient’s headache care to support his or her return to function.”

At the unit, patients gain control over their headache condition, learn to manage their symptoms and improve their quality of life. “When a patient has a high degree of disability from a disorder, we know the reality is that it begins to affect everything in the patient’s life, including relationships and work. For this reason, our focus goes beyond treating the headache—we treat the whole patient,” says Dr. Diamond.

Psychological support is an important component of treatment. Says Dr. Diamond, “We have found that a good percentage of our patients have a history of some type of abuse, whether it’s sexual, verbal or physical. Migraine is often comorbid with anxiety, depression and bipolar illness, so incorporating psychology services into the treatment plan is key for some of our patients’ long-term recovery.”

A successful recovery depends on the patient’s entire treatment team. The Diamond Headache Unit physicians and care team work closely with the patient’s primary care physician to ensure that, when the patient leaves the unit, the physician has the information he or she needs to continue the patient’s care. “We make sure the patient’s primary care physician has all of the information he or she needs, including about the care that was provided on the unit as well as the plan of care, so the physician and patient can work together to maintain the patient’s post-discharge treatment program,” says Greco.

“If you have difficult to manage headache patients, we are here to help,” says Dr. Diamond. Patient referrals can be made by contacting the Diamond Headache Clinic main intake line at 1-800-HEADACHE (1-800-432-3224) or at 773-388-6390. For more information about the inpatient unit, please visit: diamondheadache.com/inpatient/.

 

Presence Saints Mary and Elizabeth Medical Center Achieves Magnet Recognition®

Presence Saints Mary and Elizabeth Medical Center (PSMEMC) has achieved Magnet Recognition® from the American Nurses Credentialing Center (ANCC)! This honor from the ANCC distinguishes organizations that meet rigorous standards for nursing excellence and serves as a reflection of PSMEMC’s nursing professionalism, teamwork and superiority in patient care.

With this credential, PSMEMC joins the global community of Magnet-Recognized organizations. In Illinois, only 43 hospitals have achieved Magnet Recognition. Currently, only 477 of the nearly 6,000 U.S. healthcare organizations have achieved Magnet Recognition.

“Magnet Recognition is a tremendous honor and reflects our commitment to delivering the highest quality of care to our community,” said Martin Judd, President and CEO, PSMEMC. “Achieving Magnet Recognition reinforces the culture of excellence that is a cornerstone of how we serve our community. It’s also tangible evidence of our nurses’ commitment to providing the very best care to our patients, of which we are extremely proud.”

To achieve Magnet Recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. This process includes an electronic application, written patient-care documentation, an on-site visit and a review by the Commission on Magnet Recognition.

Research demonstrates that Magnet Recognition provides specific benefits to healthcare organizations and their communities, including:

• Higher patient satisfaction with nurse communication, availability of help and receipt of discharge information
• Lower risk of 30-day mortality and lower failure to rescue rates
• Higher job satisfaction among nurses
• Lower nurse reports of intentions to leave their positions

Magnet Recognition is the gold standard for nursing excellence. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet Recognition in its ranking criteria for quality of inpatient care.

The Magnet Model provides a framework for nursing practice, research and measurement of outcomes. The foundation of this model comprises various elements deemed essential to delivering superior patient care. These include the quality of nursing leadership and coordination and collaboration across specialties, as well as processes for measuring and improving the quality and delivery of care.

Congratulations to PSMEMC on this outstanding achievement!

Physician Newsletter Stories:

PHP Care Management: Case Study of 64-year-old Male

Presence Health Partners (PHP) providers, please use Care Management as a resource to support your management of complex and/or difficult patients. Following is the outcome of a recent case supported by PHP Care Management involving a 64-year-old male.

Case: Case identified from admission/discharge report.

History: 64-year-old male with Medicare Advantage with an extensive medical history. The member presented to the ED and was admitted on Sept. 29, 2017, with CVA and residual weakness, facial droop, dysarthria and dysphagia. He was discharged on Oct. 3, 2017, to acute IP rehab. He was discharged home on Oct. 11, 2017, with HHC. He also has uncontrolled Type 2 diabetes mellitus, with a last A1C of 12.3.

Barriers:

1. Member identified as high readmission risk.
2. Member’s PCP moved to Arizona and member did not have an assigned PCP for post-discharge follow-up.
3. Presence Home Health Care came to the member’s home on Oct. 12, 2017, and was unable to return because of deplorable living conditions.
4. Member lost his dentures in the spring and his ability to eat was a concern.

Intervention: The Case Manager’s (CM) initial task was to reconnect the member to a medical home. The CM worked with the member to identify and connect with a new PCP for follow-up care. The CM explained to the member why home health care would not be coming back. The CM offered SNF placement and the member refused. The CM informed the member about Elgin Community College dental program to see if he could get new dentures there for a lower cost.

Outcome: The member was seen by the new PCP. The member received outpatient referrals for PT/OT/SP, wound clinic and endocrinologist consultation by the PCP. The member is attending outpatient PT/OT/ST and going to the wound clinic weekly. The member has not contacted the dental school yet. The CM is working to build a relationship with the member to see if she can assist him further. The member agreed to the CM contacting him every two weeks.

For more information, and to refer a patient to Care Management, please contact Phyllis Smith, RN, supervisor, Care Management, Presence Health Partners, at 847.493.4663 or phyllis.smith@presencehealth.org.

Thank you.

 

It’s Time to Attest for MACRA/MIPS

Deadlines are fast approaching if you plan to submit data for the 2017 Merit-based Incentive Payment System (MIPS) performance period. As a reminder, if your Tax ID Number (TIN) was a Medicare Value Partners (MVP) participant in 2017, you are required to submit Advancing Care Information (ACI). Don’t wait until the last minute to ensure that you have EIDM access and to submit your data. The two key dates are:

• March 16, 2018, at 8 p.m. EST,for group reporting via the CMS web interface
• March 31, 2018, for all other MIPS reporting, including via cms.gov

10 things to do and know:

1. Visit qpp.cms.gov and click on the “Sign-In” tab to use the data submission feature.
2. Check that your data is ready to submit. You can submit data for the Quality, Improvement Activities, and Advancing Care Information performance categories.
3. Have your CMS Enterprise Identity Management (EIDM) credentials ready, or get an EIDM account if you don’t have one. An EIDM account gives you a single ID to use across multiple CMS systems.
4. Sign in to the Quality Payment Program data submission feature using your EIDM account.
5. Begin submitting your data early. This will give you time to familiarize yourself with the data submission feature and prepare your data.
6. The data submission feature will recognize you and connect your NPI to associated Taxpayer Identification Numbers (TINs).
7. Group practices: A practice can report as a group or individually for each eligible clinician in the practice. You can switch from group to individual reporting, or vice versa, at any time.
8. The data submission feature will save all the data you enter for both individual eligible clinicians and as a group, and CMS will use the data that results in a higher final score to calculate an individual MIPS-eligible clinician’s payment adjustment.
9. You can update your data up to the March 31, 2018, deadline. The data submission feature doesn’t have a “save” or “submit” button. Instead, it automatically updates as you enter data. You’ll see your initial scores by performance category, indicating that CMS has received your data. If your file doesn’t upload, you’ll get a message noting that issue.
10. You can submit data as often as you like. The data submission feature will help you identify any underperforming measures and any issues with your data. Starting your data entry early gives you time to resolve performance and data issues before the March 31, 2018, deadline.

For step-by-step instructions on how to submit MIPS data, check out this video and fact sheet.

If you are part of an ACO, make sure you are complying with the group’s outreach to collect patient information. The ACO is responsible for gathering specific clinical information around quality of care for all participating providers. ACO quality data reporting will be used to report on your quality scores under MIPS. You also will need to separately report on the Advancing Care Information category on your own.

Questions about your participation status or MIPS data submission? Contact the Quality Payment Program Service Center by:

• Email: qpp@cms.hhs.gov
• Phone: 1.866.288.8292 (TTY: 1.877.715.6222)

Thank you.

 

Poem, Honorable Mention, 2014 Neon Literary Magazine

Amore Sanguinis

He said I should not go— the snow was strong
and falling heavy now. The roads were dark
and covered, treacherous to ride my horse.
But staying here with him was just as bad.

I saw his eyes when I cut my hand. They
were red and shining. Demons,Father said.
He warned us in church, they live among us
and blend with humans, charm then lure us in.

I should have known, even the moon was dark
tonight. It lay behind the clouds. He looked
at me, his eyes now dark obsidian.
He held his hand towards me. Please sit down,

the hearth is warm. I felt his breath along
my neck. He brushed his lips across my jaw.
They were cold. I closed my eyes and waited.