Caring Connections

Connection: Strong Communities

A coalition for care
Diabetes partnership addresses education, quality

More than 313,000 Missourians live with diabetes. According to data from the Missouri Department of Health and Senior Services, diabetes was the direct cause of 9,450 emergency room visits, 51,025 hospitalizations and 16,112 deaths in 2005.

Assisting diabetics through early diagnosis, education and coordinated care management helps reduce the toll. In 2003, the Missouri Hospital Association awarded a four-year, $100,000 Regional Health Partnership Grant to the St. Louis Diabetes Coalition to enhance the region’s diabetes education infrastructure.

Through the grant, the coalition implemented diabetes quality improvements at SSM DePaul Medical Group and SSM DePaul Hospital in St. Louis. The program provided a care model for hundreds of diabetic patients through their primary care physicians and the hospital’s diabetes education programs. The results have been excellent, with 67 percent of patients achieving well-controlled diabetes — from a 45 percent baseline. The medical group also earned certification for diabetes care from the National Committee for Quality Assurance.

Outside the medical care setting, the grant supported the development of the coalition’s Diabetes@Work program, an employer-sponsored diabetes education program at the worksite. Eight employers, including Christian Hospital in St. Louis, have implemented the program since 2003. William Kincaid, M.D., board chair of the St. Louis Diabetes Coalition, said education is essential for improving diabetes-related health outcomes.

“Diabetes care is truly a partnership between the patient and the provider,” he said. “Today, that means giving patients the information they need to take actions to control their disease and helping providers assist in the education process while benchmarking progress.”

Chronic care management is essential in improving individuals’ lives and developing strong communities. Through strategic partnerships, MHA is helping hospitals improve community health and develop a caring connection with their communities.

A Sigh of Relief
Grant helps asthma patients at Truman Hospital Hill breathe easier

In 2002, nearly 1,300 adult asthma patients sought emergency treatment at Truman Medical Center Hospital Hill in Kansas City. These patients represented 51 percent of all area emergency department visits for asthma. However, primary and preventative care for asthma is more effi cient and produces better health outcomes.

Recognizing the problem, the Missouri Hospital Association funded a four-year, $100,000 Regional Health Partnership grant to identify root causes and solutions. The partnership included the American Lung Association, the Asthma Clinical Research Center at Children’s Mercy Hospitals and Clinics, the University of Missouri-Kansas City School of Medicine and Truman Medical Centers Inc. The goal was to create a system for at-risk adult asthma sufferers in Kansas City to help them manage their chronic condition while minimizing or eliminating ED visits.

According to Rita Mangold, asthma prevention coordinator at Truman Medical Centers Inc., process development and at-risk patient identification were key to the program’s success.

“Together with our partners, we developed tactics to address the causes of emergency utilization,” Mangold said. “We monitored asthma-based care and developed risk assessments, discharge instructions, educational programs and follow-up requirements. We provided rescue medication and nebulizers for free or at significantly reduced costs to help patients manage asthmas episodes before requiring emergency care.”

During the four-year grant cycle, care settings and chronic disease treatment models were reshaped. Throughout 2005 and 2006, ED visits for asthma at Truman Hospital Hill decreased by 40 percent while clinic visits increased proportionally. The tactics successfully redefined prevention, efficient care delivery and education on disease management strategies while reducing barriers to care and rescue tools.

The clinic-based system has been a great success, reducing emergency visits and improving asthma patient health. Through the partnership, Truman Medical Centers Inc. and its partners established a caring connection for stronger community health in Kansas City.