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Critical Path Network
Hospital, LTACH focus on awaiting transplants
Patients receive specialized care
Faced with a growing population of patients with heart failure who are awaiting a transplant and a shortage of intensive care beds, The Methodist Hospital in Houston is partnering with one local long-term acute care hospital in a program to care for patients with a left ventricular assist device (LVAD).
"We have a large transplant program and could foresee the volume growing. Since there is no way we could build more ICU beds, we look for options to ensure that the patients receive the specialized care they need," says Lynda Collins, MSSW, LCSW, director of continuity of care for The Methodist Hospital.
Collins worked with the hospital's transplant team to develop a partnership with a long-term acute care hospital to provide specialized care for LVAD patients awaiting transplant.
"The team wanted to feel comfortable with the quality of care provided by the facility where they send their patients to await transplants. They decided that the best way would be to affiliate with one LTACH and get to know their staff," Collins says.
Transplant team picks LTACH
The transplant team decided to partner with just one facility so that the staff would become highly skilled in caring for LVAD patients because they would be seeing them frequently.
"This is a very specific population with a very specific need. If the staff at a facility care for a certain type of patient regularly, they can maintain their skills. If they see one patient every once in a while, they may not maintain their skills in providing the kind of specialized care these patients need," she adds.
The hospital looked at 30 LTACHs in the Houston area over the past year, narrowed them down to five, and selected one with which to partner.
The LTACH agreed to provide a unit that could manage at least four LVAD patients at a time and signed an affiliation agreement that guarantees that the staff members are trained in providing care for these patients, she says.
The hospital transplant team educated the LTACH staff on what kind of care the patients would need. The LTACH staff received training from an outside firm on how to handle the biomedical equipment implanted in the patients and the outside pumps.
Before the affiliation agreement, the hospital had been transferring LVAD patients to several different LTACHs, but the transplant team members expressed concern that their treatment protocol was not being followed every time.
"When the patients were handed off to the LTACH team, they would go over the protocols; but when they visited the patients at the LTACH, they would find that the protocols were not always being followed," she says.
The team sent its first patient to the LTACH under the new arrangement in mid-January.
This program and others at Methodist aim at overcoming the fragmentation that is built into the health care system and its negative impact on patients, Collins says.
"When the staff at two facilities go through a process like this, it means that both sides have to talk; and when they talk, good things happen. They maintain communication and it benefits the patients," she says.