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Session Details

​​​​​​​​​​July 13, 2017, 2:00 PM ET: Greater Satisfaction, Outcomes, and Savings with Self-Administered Care

 

  • Kedar Mate, MD, Chief Innovation and Education Officer, Institute for Healthcare Improvement (IHI)
  • ​Kavita Bhavan, MD, MHS, Director of Infectious Diseases/OPAT Clinic, Parkland Center for High Impact Clinical Outcomes Studies, Associate Professor Internal Medicine, UT Southwestern Medical Center​
  • Alex Anderson, Research Associate, IHI

Patients undergoing dialysis typically do so in a hospital or health care facility. Most people don't question the need to have experienced health care staff on hand or what's considered a safe environment for the treatments. But that might be changing.

A growing number of patients in Sweden have 24/7 access to special units at health systems where they schedule and conduct their hemodialysis themselves. And, inspired by Sweden, a small number of US nephrology centers are trying something similar. Even more ambitious: One of the largest safety net hospitals in the US has been teaching a few thousand patients how to administer their own IV antibiotics at home. Talk about taking patient engagement to a whole new level! That's exactly what we're going to discuss on the July 13 WIHI: Greater Satisfaction, Outcomes, and Savings with Self-Administered Care.

We'll start with the powerful example of patients who've been trained to do IV antibiotic therapy at home, thanks to a program and research study at Parkland Health & Hospital System in Dallas. A team at the hospital, led by WIHI guest Dr. Kavita Bhavan, wanted to see if a population of patients without health insurance, whose multiple hospital days on an antibiotic drip weren't being reimbursed by anyone, might do as well and maybe even better than patients with insurance, receiving nurse-assisted IV antibiotic therapy at home, at an infusion center, or skilled nursing facility. The answer seems to be, "Yes."

A published study of comparison groups between 2009 and 2013 showed, among other things, a nearly 50% lower 30-day hospital readmission rate for 1,000 patients trained to do IV therapy at home, in addition to much higher levels of patient satisfaction. To date, the hospital has trained some 2,000 patients to handle their own IV antibiotics. Dr. Bhavan also has some new, preliminary findings that suggest something fundamental shifts for patients who are entrusted with more of their direct care, and evidence of benefits may now be showing up for other health conditions.

Alex Anderson and Kedar Mate at IHI have been carefully following Dr. Bhavan's work and that of other organizations developing patient-administered self-care programs. They will discuss how self-administered care challenges traditional roles in health care and, equally, points to more cost-effective, potentially safer care. They'll share their thoughts on key ingredients for successful programs, recently described in an article in the Harvard Business Review.

It's exciting to highlight groundbreaking QI work on WIHI. We hope you'll tune in and take part in the conversation on July 13.