Allevant Shares 10 Year Experience and Launches "Project Swing Bed on the MENDS®"
Swing Bed Culture and Attention to Wellness Vital to Rural Healthcare
MECHANICSBURG, Pa., Sept. 22, 2022 /PRNewswire/ -- On February 1st, 2023, Allevant, developed by Mayo Clinic and Select Medical, is launching the first cohort of "Project Swing Bed on the MENDS®," a Critical Access Hospital (CAH) Shared Learning Collaborative. Participating CAHs will have access to Allevant staff, tools and resources to maximize their Swing Bed program and begin to implement MENDS®, a wellness program for healthcare staff and post-acute patients.
"Critical Access Hospitals can provide post-acute recovery via Transitional Care/Swing Bed better than virtually anyone else. Their competitive advantage is their culture of safety," says Dr. Mark Lindsay, pulmonologist, Assistant Professor Mayo Clinic College of Medicine and Medical Director of Allevant Solution, LLC. "CAHs outperform larger hospitals in culture of safety surveys. Handoffs and transitions are two areas with consistently low scores across healthcare, and post-acute care is all about handoffs and transitions."
Transitional Care began in two Wisconsin CAHs 20 years ago and subsequently spread to include 11 Mayo Clinic CAHs in Minnesota, Wisconsin, and Iowa. Mayo demonstrated quality results with high likelihood of home discharge, low readmission rates, a 5-fold increase in referrals and 20 to 1 return on investment. The results of the Mayo program initiated and led by Dr. Lindsay led to the launch of Allevant approximately 10 years ago.
Jordan Tenenbaum, President of Allevant and NRHA Fellow states he is, "concerned for the future viability of rural hospitals, more than 30% of which are at risk of closure. It is a tremendous benefit for larger hospitals to partner with smaller rural CAH Transitional Care programs to ensure rural patients admitted to larger hospitals for specialty care can be cared for closer to home." He provides the example of the tertiary hospital in Eau Claire, WI where Dr. Lindsay first launched two Wisconsin Swing Bed programs. That hospital presently sends approximately 10% of their long stay discharges to CAH Swing Beds compared to the national average of less than 1%, a significant financial and quality opportunity nationally.
CAH-based Transitional Care includes important benefits such as strong team culture, higher nurse ratios, the ability to address sudden changes in condition with on-site physicians, radiology, laboratory, therapists, othr disciplines, and most importantly, a patient-centered approach that includes bedside rounds with the care team on a regular schedule. It is the ideal setting for recovering patients with complex health conditions.
With a strong focus on quality, outcomes, and growth, the Allevant team has supported approximately 100 Critical Access Hospitals across 22 states. Results from Allevant's database demonstrated an average increase in swing bed days of 55% by the second year, growth that positively impacts financial viability for rural CAHs.
More than 60% of patients admitted to Allevant-supported programs had complex medical or complex surgical conditions, a growing patient population, and only 7% were discharged directly back to acute care during a program stay of less than 30 days. The average length of stay was approximately 13 days. These are results that are not matched by skilled nursing facilities with average length of stays nearly twice or more and much higher likelihood of being discharged back to an acute hospital. It is especially discouraging that CAH Swing Bed care is often denied by many Medicare Advantage plans, a major concern for rural hospitals highlighted in an National Rural Health Association response to a recent Request for Information on Medicare Advantage that included survey results conducted by Allevant on the issue.
"We believe tracking data to compare to Skilled Nursing Facilities is essential and our data results tell an important story. We know rural patients requiring hospitalization in urban areas often do not return to rural facilities for their post-acute care. We are hopeful that our data can help educate Medicare Advantage plans about the Transitional Care value proposition and their role as a 'safety valve' for challenging and vulnerable rural patients," said Lindsay.
Allevant now provides a MENDS® health and wellness program for healthcare staff and Transitional Care patients. Life expectancy has been going in the wrong direction and rural communities are especially vulnerable to viruses such as COVID, chronic disease, and obesity. Cancers related to obesity are going to surpass cancers related to tobacco. The recent pandemic has led to high rates of staff burnout and being in a positive work environment is essential. MENDS® emphasizes key factors that have a significant impact on health, wellness, and life expectancy. Key components are Mindfulness and stress reduction, Exercise regularly, Nutrition (promoting a plant based/Mediterranean diet), Developing healthy habits, hobbies and connections, and optimal Sleep habits (and detection and treatment of sleep disorders which is especially prevalent in rural communities).
The power of the model is the synergy among the components. Gaining traction in one element helps drive success in the others. MENDS® applies social and behavioral science, the scientific method, hopefulness and the recognition that learning from failures can be the powerful stepping-stones to future success. When serving as the Quality Officer of Mayo Clinic Health System, Lindsay led an enterprise-wide Mayo Clinic Quality project targeting hypertension and diabetes at Mayo Clinic in Minnesota, Arizona, and Florida as well as a Mayo Clinic Health System site in Owatonna, MN. The project, published in the American Journal of Medical Quality, included strategies such as a healthy low sodium diet, exercise, stress reduction and a 3-element bundle (team-based order set, patient identified goal, and standardized primary care clinic blood pressure process). The effort resulted in a significant increase in blood pressure control at 3 of the 4 pilot sites.
Lindsay states, "The MENDS® and Transitional Care programs are very team oriented which is especially important with the projections of future physician and nurse shortages. Leveraging team processes and culture has absolutely driven high employee and patient satisfaction with this work." The Allevant team credits the dedication of the outstanding rural healthcare teams that provide such important care to rural communities for the Transitional Care Model success. Lindsay and Tenenbaum also credit Karl Palmer, MS, RN, a Mayo Clinic trained ICU nurse with a rural and quality background who serves as Allevant VP of Clinical Services and Operations, and Rorey Pritchard, PhD, EdS, MSN, RN, Allevant's highly experienced Senior RN Clinical Educator and Wellness Coordinator for Allevant's growth and quality results.
Allevant has participated in federally and state funded grants throughout the country, and will continue to identify opportunities to support rural providers with Transitional Care and MENDS® health and wellness programs. If you have interest in participating in the first cohort of Project Swing Bed on the MENDS®, contact Jordan Tenenbaum to learn more today.
About Allevant Solutions
Allevant Solutions, LLC, developed by Mayo Clinic and Select Medical, offers consulting services to rural hospitals and skilled nursing facilities with a focus on organizational culture, methodologies, algorithms, processes, clinical education and preparation, collaborative relationships, and quality improvement approaches. www.allevant.com
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