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1 Hospice A N N U A L R E P O R T

2 A MESSAGE FROM THE DIRECTOR: Debra Hicks, RN, BSN, MS Looking back at 2012, I wonder where the time has gone! A lot of activity occurred even though our patient census stayed about the same. Our work from last year on building relationships with referral sources has continued to this year. A committee was formed at Lourdes called Transitions with the focus of how patients transition from one care setting to the next, especially into Home Care. Representatives from Palliative Medicine, Lourdes At Home, the practice sites and Hospice made up the committee which included the Medical Directors as well. Discussions focused on how to move patients through the different levels of care the patient might need. Out of this work, we were very fortunate to get a Homecare Nurse Navigator. This registered nurse has years of service in home care and is the critical point of contact for referral sources. The navigator is available to physician offices to answer questions and provide resources in order to find the right place for the patient to transition to. We are blessed to have such a great service to offer. Also confronting hospice was a mandatory reporting requirement from the Centers of Medicare and Medicaid Services (CMS). As part of the Affordable Care Act, hospice providers are required to report on two measures: 1. The structural measures related to the content of our Quality Assessment and Performance Improvement (QAPI) program. 2. The NQF #0209 Pain Measure what is a patient s pain level on admission and what is it in 48 hours. Hospice has met all the deadlines on this requirement. If not, our payment from Medicare would reduce by 2% Hospice will continue to do our mandatory reporting and also continue our work with patient navigation. We look forward to 2013! AREAS SERVED BY HOSPICE Lourdes Hospice provides care for patients residing within Broome and Tioga Counties and parts of adjoining counties of Chenango, and Delaware. 1

3 WHAT IS HOSPICE Since 1980, Lourdes Hospice has helped individuals with a terminal illness live life to its fullest, up to the final moment. Hospice care is about receiving comfort and care when a cure is no longer possible. The Hospice program was certified by Medicare and Medicaid in 1984 and is accredited by The Joint Commission. Hospice is primarily a home care focused program that also provides care in nursing homes. Hospice supports the family in caring for the patient, enabling the patient to live at home as long as possible. When additional care is needed, our Hospice Inpatient Program can provide relief for the patient and family. Lourdes Hospice aims to improve the quality of life of the patient and family by providing physical comfort, pain management and emotional and spiritual support. Expert and comprehensive care is delivered by our specialty-trained team including: physicians, nurses, social workers, volunteers, bereavement counselors, and spiritual care counselors. Advisory Board The Hospice Advisory Board acts in an advisory capacity on matters affecting and of interest to Hospice. The Board is made up of 21 community members dedicated to serving as liaisons between community and Hospice. HOSPICE STATISTICS 2012 Patients Referred ,040 New Patients Admitted Total Patients Served (Unduplicated) Total Patient Days ,276 Average Length of Stay (Days) Value of Volunteer Hours Donated $223,130 Average Daily Census: in January in December 2012 Percentage of patients that died within 30 days: 66.23% We are focusing our attention on quality, positive patient outcomes, building strong relationships with referral sources, staff recruitment and retention, assessing our referral and intake process, paperwork and flow efficiencies, and a strong emphasis on patient/family satisfaction. 2

4 FAMILY SATISFACTION 2012 SURVEY RESULTS: 425 Families responded to the National Hospice and Palliative Care Organization Family Satisfaction Survey regarding Lourdes Hospice. A few of the results are listed below: 100% stated they would recommend hospice services to others. 96.6% stated that the Hospice team clearly explained the plan of care. 98.4% stated they received enough instruction of patient care. 100% stated they were always treated with respect by the Hospice team. 94.1% stated they were given enough information on pain management medications. 94.9% stated they received enough information on end of life expectations. PROGRAM HIGHLIGHTS An interdisciplinary team of compassionate health care professionals and volunteers provide a planned program of care and support for the patient and family. Using a comprehensive case management approach, the goal of Hospice care is to provide an alert, pain-free life and to manage other symptoms so that patients can live as fully as possible. Medical The Hospice Medical Director (MD) is a physician who participates in the admission and ongoing care of our patients. The patient s attending physician remains an integral member of the Hospice Team in planning for the patient s care. The MD supervises our Nurse Practitioner who does our face-to-face regulatory requirements. Our MD is an active participant in our IDG meetings. Nursing Hospice nurses work very closely with the patient s physician to keep the patient at the patient s preferred comfort level. They also teach the family members how to provide care and educate them on what to expect as the patient s condition changes. Our nursing team is available 24 hours a day, 7 days a week. Our laptops allow us to have the most up-todate patient information at our fingertips. This increases safety and quality for our patients. Hospice Aides provide personal care and support to patients working under the supervision of Hospice Nurses. Hospice nurses made over 5,800 visits in Social Work Hospice Clinical Social Workers (MSWs) provide counseling services and guidance to support our patients and their families. Social Workers help with coping strategies, personal Life Review, assessment of depression and anxiety and assist the nurse case manager in planning for appropriate patient care needs. Social Work services are available to our patients, not only during regular business hours, but as needed through our on-call MSW services. This service is provided to our Hospice families 24 hours a day, 7 days a week. The social work department provides bereavement services through our bereavement counselor. Social Work made over 2,142 visits and 2,073 phone contacts in 2012, serving more than 1,623 recipients. Spiritual Care With the approach of death there commonly occurs an inward journey to consider the questions of human existence and the meaning of life and death. Persons of all beliefs may need assistance in addressing spiritual issues at end-of-life. The Hospice interdisciplinary team is trained to identify patient needs in the area of spirituality. The Hospice Chaplain and his team is available, when needed, for our hospice patients and their families to provide spiritual guidance and counseling. Follow-up support is given when necessary or linked with community affiliations when desired. The Hospice Chaplain and his spiritual care team play an integral part on the Hospice Care Team. Spiritual Care made 1,113 visits and 574 phone calls in 2012, serving more than 228 recipients. Volunteers Last year, Hospice volunteers donated over 10,250 hours and drove 35,000 miles. They 3

5 complete a comprehensive training and personal enrichment course of 30 hours. This provides an overview of Hospice philosophy and brief history, the team concept and holistic approach to care, the emotional, spiritual and cultural issues related to death and dying, effective listening and communication skills, how to care for yourself while caring for others, coping with grief and bereavement and much more. Volunteers provide a wonderful service of helping others in need during a difficult and challenging time in patient s lives. They provide patient and family support, grocery shopping, errands, bereavement support, office assistance and deliveries of medications. Volunteers choose assignments that best suit their time and availability, skills and interests. There is also training for hand aroma therapy using essentials oils for relaxation for the patient. Volunteers made over 1,200 Baskets of Love for patients birthdays, anniversaries, holidays and inpatient stays at Local hospitals. They go Christmas caroling to selected patients home and nursing home during the Holidays. The Some Bunny Loves You program is in its third year. The bunny is soft and cuddly and is given to our patients in the hospitals. They are a comfort to those who are alone and we have found that they are a wonderful memory for the family once their loved one has passed. They are made from donated material such as quilts, cotton or chenille bedspreads. The volunteer also designed two labels for the bunnies. One is Some Bunny Loves You and the other is From Your Hospice Volunteers. There are also volunteers that sew beautifully patterned gowns for our female patients and solid colored gowns for the male patient. They also crochet or knit lap robes. Another caring avenue for the volunteers. The Sacred Watch program continues to assure that no one dies alone by providing patients who are in their final stages of life with a compassionate companion to sit by their bedside. Sometimes there is no family and this program provides a reassuring presence for the patient. Or, if the family needs respite, the volunteer can sit with the patient assuring the family that their loved one is not alone. There are baskets provided that include a CD player and relaxing music. The volunteer proudly wears the Sacred Watch pin which identifies their ministry. In 2012, over thirty patients and their families were assisted by the volunteers. Assisting the terminally ill patient through Hospice is not about dying but about living, states the Hospice volunteers. Bereavement Family members receive counseling and grief education benefits throughout the first thirteen months of bereavement. Support is offered to the bereaved through bereavement newsletters, phone calls, support groups, bereavement buddies, short term individual counseling and referrals are made to local agencies for long-term individual counseling as needed. Approximately 630 hospice families as well as over 100 community members benefitted from bereavement follow-up services in Trained bereavement volunteers made routine bereavement phone calls to the bereaved at least every three months. Trained bereavement volunteers made high risk bereavement phone calls to those bereaved with additional needs at a frequency of once a week to once a month. Bereavement Newsletters were sent out quarterly to the hospice bereaved families. Several Bereavement support groups were offered: eight week educational groups, monthly drop-in groups in the Vestal and Owego offices, Men s only drop-in groups, Widow s only support groups, Young Adult Support groups, Hope for Family Support Groups and Getting through the Holidays groups. The 6th annual, Camp Hope for Kids, a special project by Lourdes Hospice and Broome Oncology was held in August. Thirty-six children and adolescents ages 6 14 years who experienced the loss of a loved one attended. Community Grief education and/ or support was offered at several local schools, agencies and organizations. Educational presentations included; When Professionals Grieve, Caring for the Caregiver, When Grief Hits Your School, and Children s and Adolescent s Grief. A Celebration of Life Service was held in November The lives of forty-five loved ones who passed away in Lourdes Hospice Care were celebrated. Nursing Homes Hospice serves patients in the 6 nursing homes in Broome and Tioga Counties. In the year 2012: Hospice provided care for 88 nursing home patients. In 2012 we lost two nursing homes to devastating floods and beds were drastically reduced. Continued on page 5. 4

6 PROGRAM HIGHLIGHTS Continued from page 4. Hospice Inpatient Program The Hospice Inpatient Program which includes respite care is located on the first floor of Lourdes Hospital. Our rooms are designed for comfort, privacy and home-like atmosphere. We have designated an inpatient team consisting of RN, MSW, spiritual care and volunteers to provide consistency in overseeing the care of our patient s in this setting. Having this team on site daily allows for a more timely response to answer questions or provide support. It also enhances relationships with the inpatient staff. The same services are also offered at Binghamton General Hospital, Wilson Medical Center, and Susquehanna Nursing and Rehabilitation Center. Additional Services Our hospice program offers other comprehensive services including management of medications, home care supplies and equipment. We also provide consultations with dietary, physical therapy, speech therapy, occupational therapy and respiratory therapy professionals. Community and Professional Education Lourdes Hospice is dedicated to promoting and providing education about end-of-life care, not only to the patients and families we serve, but to the community as well. Hospice provides education and clinical experiences to medical students, nursing students, high school students and other health care professionals. Staff and volunteers from Hospice have attended many community events including health fairs, church events, the ALS support group, and Alzheimer s Association Caregiver classes. Broome Community College and Binghamton University continue to invite Hospice staff to present to their students attending Death and Dying, Human Development and Medical Office Assistant Classes. Lourdes Hospice now has a Homecare Nurse Navigator who serves as a critical point of contact for referral sources including physicians, hospitals, rehab and nursing centers, senior centers, and caregivers to provide assistance with accessing Home Health, Hospice, and Palliative Care needs. The Homecare Nurse Navigator also assists in development and implementation of specific programs related to home and community based services. In-Services are provided annually to area nursing homes and hospital staff regarding hospice services and end-of-life issues. The Homecare Nurse Navigator continues to carry out the marketing program started in The focus of the program is to be available to the physician offices to answer questions and provide resources, as well as educate our referral sources on end-of-life issues. Visits are made routinely to physician offices and referral sources throughout Broome and Tioga Counties. Quality Lourdes Hospice operates under the Performance Improvement and Patient Safety Plan through Lourdes Hospital. Lourdes Hospice defines the quality assessment performance improvement (QAPI) as required by the Medicare Hospice Conditions of Participation. The QAPI model is intended to give the Hospice department a comprehensive, 360 degree self-assessment of the services provided to hospice patients. The review process encompasses all aspects of Hospice performance, including service utilization, financial measures, admission/referral activity, intake outreach activities, discharge summary, clinical/qi performance measures, infection control, volunteer utilization, human resources, Family Evaluation of Hospice and bereavement care, Associate Engagement Survey, and Nursing Satisfaction Survey. The compiled data is used to create a monthly dashboard report, which is reviewed by the HQIC Committee for the purpose of recommending and implementing quality improvement decisions and identifying educational needs of the department staff. The QAPI Committee initiates Performance Improvement Projects (PIP) from the review of data collected, defines who will complete the PIP, what role each person will have, and establishes a timeline for completion. The HQIC committee reviews the overall effectiveness of PIPs. Foundation Lourdes Foundation accepts the generous donations received from our patient s loved ones and friends as well as the community. This generosity allows Hospice to give back to other patients who are in need. 5

7 SPECIAL EVENTS Tioga County s Annual Tree of Lights The annual Tree of Lights event held in December was successful once again for Tioga County s Friends of Hospice. Proceeds from this event are used to support Hospice West families. Lourdes Hospice Memory Angel for 2012 Hospice offered the beautifully handcrafted line of collectible ornaments again in Hospice sold over 500 ornaments and raised more than $7, The Memory Angel was designed to be given as a gift of remembrance of a special loved one. These are cherished ornaments to family and friends. The ornaments were offered in November during Nation Hospice Awareness Month and again in December to support Hospice and to continue to bring the message of hope to patients and their families. Hospice offers the beautifully handcrafted line of collectible hand crafted keepsake ornaments. All ornaments are slip cast porcelain, handmade by talented craftsmen and women. Each piece is highlighted with mother-of-pearl, kiln fired and hand polished to give a silky smooth finish. Each ornament has bow and ribbon by which to hang it. Gift box included. The ornament was designed by Nancy Jeanne Designs, a two generation family owned business whose core philosophy reflects the same issues of care, compassion and support that mark the health care community that it serves. The owners, Bill Dransfeldt and his wife, Leeanna, a professional nurse, have worked closely with many hospices to create other keepsake ornaments. It is our hope to continue offering a new keepsake ornament form this collection each year. FAMILY COMMENTS I bless the day Hospice showed up. The team was the best in every way possible. Hospice made end of life for my Mother smooth. They prepared me for the end, although a son is never ready to lose a parent. Thank God for Hospice. My husband received excellent care from the whole Hospice team. They were caring and did an exceptional job preparing me for those final days. Our experience with Hospice was exceptional and extremely caring and compassionate. Our questions were answered and all information regarding our Mother s condition, etc. was always answered or a phone call away. Thank you for your dedication. We received great support from the Hospice team. They were always there for us, especially the day Mom died. The nurse and social worker were excellent and helped us every step of the way. Hospice gave Mom wonderful quality of life during her last few months. Thank you. I appreciated the help and explanations provided before and during my wife s last days, as well as the informal sharing of our respective spiritual journeys which was very encouraging and supportive. God Bless you for all your wonderful work. I would highly recommend Hospice to others. They are always available to the family which is a great comfort. Their concern makes the whole end of life journey easier for all. Thank you so much. 6

8 Hospice 4102 Old Vestal Road Vestal, NY Lourdes Hospice Lourdes Hospice West 231 Main Street Owego, NY Return Service Requested Nonprofit Organization US Postage PAID Permit No. 104 Binghamton, NY 13905

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