The Vulnerable Among Us - President's Perspective

St. Luke's Hospital image

What I should be writing about this month is the impending conversion of Iowa’s Medicaid program to what’s being called “Managed Care” as of January 1st, 2016, but I’m not because there are simply too many unknowns about how this conversion is actually going to work. What is clear is that there are less than three short months left to figure out a myriad of issues and details for a program that will be the nation’s first “wall to wall” conversion of all Medicaid programs in a single year, affecting over half a million of our most vulnerable Iowan’s. More on that next time, but stay tuned.

St. Luke's NICHE designation

So instead I’ll write about our other most vulnerable population in Iowa, our elderly. According to 2013 data from the US Census Bureau, nearly 16 percent of Iowa’s population is over age 65. And data from the Pew Research Center, predicts by 2030, that number will reach 18 percent as the last of the Baby Boomers turn 65. These are people and family members we all know, but in many ways do not. One way UnityPoint Health – Cedar Rapids is being proactive in better serving our more elderly patients has been through achieving a NICHE designation which stands for Nursing Improving the Care of Healthsystem Elders.

NICHE is the leading nurse-driven program designed to help hospitals and health care organizations improve the care of older adults. The vision of NICHE is for all patients age 65 and over to be given sensitive and exemplary care by providing principles and tools to stimulate patient-centered care for older adults.

One of the key initiatives of UnityPoint Health – Cedar Rapids has been the introduction of the Geriatric Resource Team (GRT). The GRT will participate in online and classroom education sessions and will play a key role in assessing, planning, implementing, evaluating and documenting geriatric care according to geriatric best practice protocols. Currently there are 500 hospitals that are NICHE designated and only nine in Iowa. St. Luke’s is the first hospital in Cedar Rapids to earn this designation.

Our Commitment

Our nursing leadership went through a six-week NICHE Leadership Training Program and submission of an Action Plan specifying interventions which will be implemented to enhance the care we provide to older adults. What does that mean? It means we put our key leaders in our patients’ shoes and looked at ourselves through their eyes. We put goggles on to reduce clarity of our vision, put in earplugs to simulate hearing loss. We wore gloves over gloves and filled them with rice to mimic the loss of touch that many elderly experience in completely invisible ways to care givers be they nurses, social workers or administrators.

All this means we felt it important to step back and take a fresh look at a population of people many of us take too much for granted. After all, we all know older folks. Heck, some of us are older folks! But as one who only recently has begun to play a new role as a partial care giver to his own parents, it has quickly become obvious to me that while I’ve been around aged people my entire life, I’ve never been able to see their world through their eyes, nor feel the frustration of no longer having either the independence or the capabilities of meeting all my own needs the way I want to meet them. It’s been eye opening, humbling, frustrating and rewarding all at the same time. And this was all for people just like the ones I see every day in our clinics and hospitals.

Pursuing NICHE was our way of refocusing on this most vulnerable of populations we serve, recognizing there was more we could do to better anticipate their needs and desires, reminding ourselves there go we in not so many more years, and if we don’t see these people more clearly now we’ll never be able to give them the healthcare we’d want our loved ones to receive in the future.