Innovation In Action

Connection Strategy Project:

Our Innovation Center opened in 2011 and we have implemented significant projects to improve the way we deliver healthcare. Following are some of the ways we are thinking beyond at Columbus Regional Health to be your health and wellness partner:

Project Summary: Navigating the healthcare system can be complicated and confusing for patients and challenging for healthcare providers to coordinate care. Through a strategic planning process, Columbus Regional Health prioritized the need to help patients and their families better navigate the various parts of their health system. What if there were a "place", virtual or real, where a community of people could connect to a health system and no matter what their circumstances they would find answers they need? Think of an Apple Genius Bar for health.

Our Approach: Facilitated by our innovation consulting partner and internationally renowned design thinking firm IDEO, and with participation from leadership across all areas of the health system, the team will endeavor to make our health system function better for our community.

What’s Unique: The project, funded by Columbus Regional Health Foundation, is one that very few health systems can tackle. “Columbus is unique in that the closeness of its community, the coordination between the stakeholders, and the stability of its population allow for investments in the community’s health that might not be viable in other situations,” said Stacey Chang, Director of IDEO’s Healthcare Practice. Our unique approach of using design thinking tools to unlock and experiment with the best patient-centered ideas has the potential to transform our community’s healthcare experience and to make the process better in navigating our healthcare system.

Diabetes Health Coaching Project:

Project Summary: Adults in Bartholomew County suffer from diabetes at a higher rate than both the state and national averages. The burden is greatest for adults over 65: 1 out of 4 has diabetes. To help people with diabetes better manage their condition and avoid further complications, CRH and six primary care offices formed a two-year Diabetes Health Coaching Demonstration Project to support 5,000 patients. The project is based on a proven patient-centered coaching model tested over six years at Volunteers in Medicine that has resulted in benchmark health improvements for diabetes patients.

Our Approach: Health coaches are non-professional healthcare providers who are trained to help patients adopt healthier habits that focus on seven behaviors: eating healthy, being active, taking medication, monitoring, problem solving, reducing risk and healthy coping. With oversight from a physician champion and certified diabetes educators, coaches work with patients to develop a personalized care plan and offer them ongoing education, encouragement, and support. Unlike the current care delivery model where patients and physicians only have a few minutes together, coaches are able to spend much more time with the patient and establish rapport.

Role of Foundation: Funding from Columbus Regional Health Foundation supports the costs of four health coaches who meet with patients across the six practices. The program is provided at no cost for patients, who otherwise would not have access to health coaches through health insurance.

Results: Since the launch of the project, patients have seen significant improvements in key diabetes health measures with an average drop of 1.2% in A1C levels. The A1C is a two-to-three-month average of a person's blood sugar levels, and studies show that for every percentage decrease in A1C levels, patients will experience a 30% relative risk reduction. Not only are patients healthier, but both patients and providers are more satisfied with the coaching program. "[The health coaching model is] such an improvement from the traditional way in my opinion," said Dr. William Lustig, a family practice physician participating in the project.

Patient-Centered Medical Neighborhood Project:

CRH Nationally Selected: In 2012, Columbus Regional Health was selected by the CMS Innovation Center in Washington, DC to participate in a nationwide, 15-hospital initiative to transform the patient experience. CRH was the only Indiana hospital selected for the initiative, and we were chosen for our readiness and proven ability to quickly innovate care delivery. Led by innovation project partners *TransforMED, Phytel, and VHA, and funded by a three-year, $20.75 million CMS grant, the Patient-Centered Medical Neighborhood Project advances the concept of the Patient Centered Medical Home (PCMH) and links these primary care "homes" to each other and to specialty practices to become a network of "neighborhoods."

Background and Intent: A PCMH connects providers in eight primary care offices with all other healthcare providers that comprise a patient's care team for a more coordinated experience (this team includes Columbus Regional Hospital, specialty, subspecialty practices, and community health resources). This care team - centered on the patient - works together with a shared goal of improving the individual's care.

What's Unique: Since the start of the project, the eight participating practices have significantly transformed care delivery processes to be more patient-centered. Improvements among seven PCMN initiatives have resulted in primary care physicians being able to:

• book more same-day appointments
• develop patient portal access for 2014,
• coordinate care delivery across all healthcare settings
• collaborate with CRH to help reduce readmissions after an ER or inpatient visit
• improve patient self-management support and education

Additionally, Phytel software enables this network of care providers to more proactively manage their patients, resulting in better health outcomes for patients at the most efficient cost. Physicians have better tools to measure quality of care; eliminate gaps in care and address those through immediate follow-up care; and benchmark and trend information by provider/practice to better track preventative and disease state measures.

Expected Outcomes: Research shows that these patient care neighborhoods will lead to better care, lower costs, and will improve the patient-provider experience. CRH’s national recognition as a leader in health system innovation will result in a local population that’s healthier and a health system that collaborates more effectively.

*TransforMED is a subsidiary of the American Academy of Family Physicians and has supported more than 700 primary practices throughout the U.S. transition to the PCMH model.

*Phytel provides population health improvement software so physicians can coordinate and better manage patient care.

*VHA is a nationwide network of community-owned healthcare systems and physicians.

WellConnect:

Our WellConnect location opened in downtown Columbus in December 2013. WellConnect was born from our focus on innovation and our vision to be your health and wellness partner for life. The modern, comfortable environment is unlike a traditional health experience. We are open to the public to offer an opportunity to connect with wellness experts, healthcare professionals and others to offer a different and better health and wellness experience. The center serves as a real-time innovation lab, as we actively seek the public’s input on new services to better meet their needs.

Berman Project:

Background and Intent: In 2005, Fred and Karen Reams gave $400,000 to Columbus Regional Hospital to establish the L. Paul Berman Memorial Fund for Patient Care Excellence. The Reams gift was offered as a matching gift challenge to the community and an additional $500,000 was donated to the endowed fund. In addition to honoring their friend and former CRH trustee Paul Berman, Mr. and Mrs. Reams intended for their gift to encourage innovations that enable CRH to rapidly adopt the latest and best clinical practices and to support CRH innovations to eliminate unnecessary costs in healthcare delivery. The Berman Fund was a catalyst to the development of the Innovation Center and each year underwrites a critical innovation project at CRH.

2013 Project: The 2013 Berman Project funded benchmarking visits for our Connection Strategy project. As part of our intentional innovation framework, we take a systematic approach to identify best practice in organizations around the country that are doing related work and can inform us on our own innovation projects. These are the organizations that CRH leaders visited and learned from:

• IDEO
• Mayo Clinic, Rochester MN
• Palo Alto Medical Foundation Clinics
• Druker Center for Health Systems Innovation
• Apple Inc. flagship store
• Emblem Health Neighborhood Care Center
• California Healthcare Foundation
• One Medical Group

Their innovation strategies for improving the patient (customer) experience align closely with our own strategic innovation goals. These benchmarking trips will help guide us in our own innovation journey as we apply the ideas and contacts we gleaned from the visits to advance the work of the Connection Strategy Project Team and the continued development of our Innovation Center.

Leonard Fellowship Winner:

What It Is: The Leonard Fellowship was established in 2007 by the hospital trustees and the Foundation Board following Doug Leonard's retirement in 2007 as CEO of Columbus Regional Hospital. The Leonard Fellowship was created to honor Doug's passion for innovation in the care of patients, to recognize his legacy as the inspiration for the Innovation Center, and to encourage and recognize accomplished innovators at Columbus Regional Health.

How It Works: The Leonard Fellowship is awarded every two years to an accomplished innovator at CRH whose work has demonstrated major impact on CRH patient care, has the potential for continued impact during the fellowship period, and has the potential to be recognized nationally. The $10,000 Fellowship supports innovation work during the fellowship period.

Fellows can be nominated by any CRH employee or medical staff member. To win the Innovation Fellowship, recipients must be held in high regard across the hospital, must be nationally recognized for innovation work, and have demonstrated major impact on CRH patient care.

2013 - 2014 Leonard Fellow: David Lenart, Director of Facilities and Materials Management

Among his many accomplishments, Dave has participated in numerous cutting-edge vendor participation efforts including Nurse Call System, Building Automation System and most recently the 2012 Power Partner Award from Duke Energy. All these awards received national and/or international recognition.

Dave presents regularly at local, state, and national conferences and professional venues on patient satisfaction, employee engagement, improving patient and staff workflows, benchmarking supply costs, facilities excellence, and disaster response and recovery.

Dave led the physical recovery of Columbus Regional Hospital in 2008 from a historical flood that shuttered CRH, restoring all hospital services, infrastructure, and operations to functionality within five months.

Results: Part of his work during the rebuilding process was to look at ways the hospital could innovate to become a leader in sustainability and energy efficiency. The energy savings in turn would be used to improve patient care. The results of these efforts led to an approximate annual savings in energy costs of $75,000.

• 2013 – 2014 Fellow: David Lenart, PE, MBA
• 2009 - 2011 Fellow: Caroline Sims, RN, BSN, MSN, PhD
• 2007 - 2009 Fellow: Jennifer Dunscomb, RN, CNS