Creating a multidisciplinary executive care team to manage chronic obstructive pulmonary disease (COPD) is improving patient outcomes and cutting costs significantly at Sanford Medical Center in Fargo, North Dakota.
Managed Healthcare Executive (MHE) asked team leader Becky Anderson, a registered respiratory therapist and manager of Respiratory Care Services at Sanford, to elaborate.
MHE: What is the history of the executive care team?
Anderson: We started the program in 2008, as a way to reduce cost for COPD exacerbation treatment in the hospital. We also wanted to impact adherence to evidence-based care.
The director of respiratory care led development of the COPD inpatient care program. He initially recruited our pulmonologists and the hospitalist department chair, plus a clinical pharmacist to balance medication efficacy with cost. Soon after, colleagues from nursing, social services, finance, and quality joined. Information technology (IT) also became an integral part of the project to ensure our electronic health record (EHR) supported the work.
Today, our team is comprised of approximately 10 members across disciplines.
MHE: What are some of the team’s notable achievements?
Anderson: Over the years, we have reduced cost of care, which had been a negative net margin of $615 per admission, to an average of $1,400 per admission.
We have also improved adherence to evidence-based care for COPD exacerbation from an original 57% to above 90% over the past six years.
Perhaps most important, though, is that within six months of starting the program, we cut our readmission rate in half. In addition, our mortality rate improved to better than the national average.
These goals were made possible through buy-in across disciplines and the addition of a new position: the respiratory therapy COPD clinical specialist. These therapists work with both patients and the interdisciplinary team to facilitate improved healthcare-related outcomes for COPD patients.