John Murgai and Lee Rose have helped Brookhaven Administrator Mollie Wooldridge (left) and Director of Nursing Dustin Schuler, RN, (third from left) keep residents healthier.

by Mike Lee, Staff Writer

Like any good administrator, Brookhaven Extensive Care’s Mollie Woolridge is constantly looking for better ways to help her residents.
So when she heard about the Prevent Clinic and what it could do she was sold.
“We always want to give the best care for our residents so anything that’s new and can make their lives better or easier we want to try,” Wooldridge said. “What they pitched to us was what we needed because readmissions are an issue and these can prevent some. It can at least let us know when someone is declining.”
Enter John Murgai and Lee Rose with Prevent Clinic – an on-site health monitoring and management firm that specializes in identifying patients who are at-risk for hospital readmission.
Once those patients are identified, Prevent Clinic focuses on continued monitoring until the patient’s prognosis improves.
Patients in the Prevent Clinic – largely those with congestive heart failure – are examined once they begin the program and are then seen weekly.
“We know from the start if they are at risk and what to look for and they are monitored regularly by additional people,” Wooldridge said. “And it’s people that learn to know them.”
Brookhaven specializes in nursing care. And Dustin Schuler is the Director of Nursing.
From a clinical standpoint, he was all for using Prevent Clinic.
“It was just giving us an extra tool to care for the residents,” he said. “For a long time with skilled care you had to send them out to the hospital to get any kind of testing done. It was just a great option to help the residents.”
Wooldridge monitored the numbers and liked what she saw.
“When did this work? From the very beginning,” she said.
Prevent Clinic’s ultrasounds and dopplers are also at Schuler and his staff’s disposal.
“The technology the mobile x-ray has is pretty high-end,” he said.
“Once I got the nurses on board 100 percent it was definitely additional peace of mind,” he continued.
“I think they like it, knowing there’s another test they could run. It gives them something else we can go to. They realize sending the resident to the hospital isn’t good for them and it isn’t good for the family.”
Health care reform has pinpointed hospital readmissions as a key area for improving care coordination and achieving potential savings.  Medicare patients have the largest share of total readmissions and the highest associated costs for readmission.
According to the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, there were approximately 3.3 million adult hospital readmissions in the U.S. in 2011. That resulted in $41.3 billion in additional hospital costs.
For Medicare patients, the No. 1 condition resulting in readmission was congestive heart failure which was responsible for 134,500 readmissions. Septicemia and pneumonia were the next two conditions responsible for the majority of readmissions. These three conditions alone resulted in $4.3 billion in hospital costs.
At a time when hospitals are trying to lower a patient’s length of stay, patients are unfortunately coming home sicker than before.
The thinking is that objective hemodynamic data can lead to better outcomes and ultimately a lower cost of care.
“It’s an added plus on our side because we do something nobody else does,” Wooldridge said.
Initially, Wooldridge admits her staff was leary of taking on a new process. But Murgai quickly won them over.
“Trying new things is always difficult because you don’t want to add more work to already overworked people,” Wooldridge said. “But I think this helps them in so many different ways. It’s not additional work it’s additional eyes on our residents. More people can see a decline or an improvement.”
Murgai said Brookhaven is the first facility to use Prevent Clinic’s optimized program.
“We test every patient here,” Murgai said. “Every patient gets tested … that way nothing falls through the cracks for them.”
And the cracks are where patients can slip through, leading them back to the hospital.
“Hospitals are where sick people are and people get sicker sometimes when they go there,” Rose said.
That’s why keeping them out of the hospital is the best prescription.