A Simply Smiley Finish:

Celtic’s Miles of Smiles

WE DID IT!  In fact, we EXCEEDED it!  When Celtic Healthcare launched our 1^st Annual Miles of Smiles Month at the beginning of January, our goal was to make 5,000 people smile.  We did that and more - rewarding 5,686 smiling faces from Northeast Ohio all the way to Carlisle, PA – and everywhere in between.

Did we see you smile?  If so, perhaps we handed you a Smiley cookie, a sticker, or a free pass to one the Carnegie Museums of Pittsburgh.

Remember why we want you to smile!

• Smiling makes us look spectacular.

• Smiling helps us beat stress.

• Smiling lowers blood pressure.

• Smiling is contagious.

• Smiling boosts our self-esteem and our immune system.

• Smiling releases endorphins, natural pain killers and serotonin.

• Smiling gives us a natural facelift.

This initiative is brought to you by Celtic Healthcare in partnership with Eat 'n Park, WJAS, WISH 99.7, Comcast, and Carnegie Museum of Natural History.

Don’t stop now!  Smile today, tomorrow, and for weeks to come.

Coming Soon:  Celtic Healthcare "hearts" all of our referral sources, patients, clients, and associates.  Learn more from February 11 - 14.

Find Us On…

Are you on Facebook?  Because WE ARE!  Become a fan of Celtic Healthcare by searching “Celtic Healthcare” when you are signed on.  Help spread the word that Celtic Healthcare is on Facebook!

Eldercare:  Finding the Way in Full-Continuum Home Healthcare

Who is really in charge of care as a patient moves across the continuum?

By: Marian Essey, RN, BSN, Vice President Performance Improvement, Celtic Healthcare

Healthcare providers regularly face the challenges of improving the quality of care for patients they serve.  The patients, too, face challenges, as our current health system provides care that is siloed, complex, and difficult to navigate.

Quality may be defined not only as it relates to quality measures for individual provider settings, but also in terms of the quality of care that occurs during care transitions (as patients move from one setting or location to another).  These movements or transitions are often unplanned and may occur at the most unforeseen times, such as nights or weekends, when healthcare delivery systems are tested because of staff shortages or busier environments.  To complicate matters further, the patient and caregivers are generally ill-prepared for their role in the next care setting.  Often transitions in care are the result of unplanned acute problems that the patient has not anticipated, does not understand, and is not prepared to handle adequately.  Patient safety can be jeopardized when this situation occurs, and medication mismanagement may also occur.  Patients who are cognitively impaired offer an even greater challenge, and are potentially at even higher risk for adverse events occurring as care is transitioned across the continuum. 

Since we work in such complex systems, there is generally not a single practitioner who takes the lead in coordinating the patient’s care between settings, from the sender to the receiver.  Who owns the patient during care transitions—the sending team or receiving team?  How can we decrease the probability of adverse events such as medication errors or avoidable hospitalizations?  Since there are no standardized measures for publicly-reported care transitions, how can we measure the quality of transitional care?

Let's keep in mind that care transitions often leave patients vulnerable to additional healthcare issues such as:

�?� Medication errors caused by multiple providers and insufficient communication among providers, possibly with multiple pharmacies involved as well

�?� Lack of understanding how to self-manage care (as diagnoses, medications or treatments may be new the patient, they often lack the knowledge of how to adequately self-manage their care as they are transferred across the continuum)

�?� Communication errors (due to multiple providers from multiple settings)

�?� Duplication of tests or services (again due to insufficient communication)

Providing optimal patient care during transitions has a seemingly endless list of challenges, but there are also many opportunities.  Certainly the greatest opportunity is to provide true patient-centered care -- care that is respectful and responsive to individual patient preferences, needs, and values and ensures that patient values guide all clinical decisions.  How can we achieve this?

First, each setting must have policies and procedures in place to ensure that for their patients the “care does not stop here.”  In other words, their policies, procedures, and practices ASSURE that patients are not just handed off to other providers, but that care truly continues across the continuum as a finely executed set of events with the patient’s needs at the forefront.  Secondly, the quality of care transitions needs to be MEASURED in each setting.  The only way to improve care is to measure care, and to then make adjustments as needed to guarantee excellence in care.  Third, when possible, select providers in other care settings as partners and reduce the pool of providers to those that truly meet high standards of care and are committed to quality transitions.

To answer the original question, “Who is really in charge of care as a patient moves across the continuum,” the answer is:  WE ALL ARE.  If we cannot passionately accept that challenge, we should be prepared to be replaced… because there is always another healthcare provider out there that will gladly step into our shoes and meet this challenge.