ACOs: How does a clinical case coordinator benefit the patient?

We continue our discussion of the Franciscan Alliance ACO by answering the following question:

“How does a clinical case coordinator benefit the patient?”

Clinical case coordinators will work with our patients to make sure they are getting the right care at the right time. Sometimes, the case coordinators may reach out directly to assist patients or return patient calls to possibly help with any of the following:

  • Answering questions and giving information needed to understand the conditions managed by their doctor
  • Explaining the choices a patient has for care and helping decide which one is best
  • Guiding the patient through the health care system, especially when more care is needed from specialty doctors
  • Helping improve the health of the patient by offering opportunities to discuss wellness, prevention and follow-up care
  • Tracking care among all heath care providers
  • Reminding patient of the full range of preventive services that are available

Next week: “What can a patient expect if their doctor is in an ACO?” and “How will an ACO lead to better care for our patients?”

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Kaitlyn Bragg honored with 2014 Maria Petti Scholarship

Kaitlyn Bragg recently was the 2014 recipient of the Maria Petti Scholarship granted each year by Franciscan St. Anthony Health-Michigan City.


The $5,000 award was established in 2009 in honor of Petti, one of Franciscan St. Anthony-Health’s most highly regarded nursing professionals, who died from cancer at age 53 in August 2008. The scholarship is paid directly to the recipient’s school to help defray the cost of tuition.

Bragg attends Valparaiso University in her hometown where she expects to complete a bachelor of science degree in nursing in May 2016. She is vice president of the university’s Student Nursing Association and a member of the Alpha Phil Omega co-ed service fraternity. She also works on Sundays as a youth mentor at St. Teresa of Avila Catholic Student Center in Valparaiso.

Bragg, a 2012 Valparaiso High School graduate, hopes to continue her education after receiving the degree by working as a surgical pediatric nurse in Northwest Indiana. She currently is an registered nurse fellow at another area hospital and hopes to be an RN fellow at Franciscan St. Anthony Health next summer.

Bragg said she was grateful for the scholarship and hopes to continue the legacy of Maria Petti through service to the area.


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40 years later, P.R. Unni, MD, has no plans to leave to leave Franciscan St. Anthony Health

After joining the Franciscan St. Anthony Health – Crown Point medical staff in July 1974, just four months after the hospital opened, and being the lone physician remaining since that first year, P.R. Unni, MD, has seen growth and improvements in myriad areas.


But an aspect that may not have been surpassed since the early days is one many people might not expect — the cafeteria food.

“The patients and doctors really appreciated the food – it was some of the best in town. Restaurants would complain that they were losing business because of our cafeteria. Doctors would look forward to having dinner meetings here and we were told that even people who didn’t have to be at the hospital would come here just for the food,” Dr. Unni said.

The urologist said he was drawn to the hospital by a physician-friend who recommended it and by Crown Point’s “cozy, quiet, friendly atmosphere,” that remains to this day.

“It was a brand-new, modern hospital that became very busy and competitors were opening satellite branches to compete. We had an excellent staff – the nurses were friendly and the patients were very happy; they preferred St. Anthony to other hospitals,” he said. It also attracted his son, Ramesh Unni, M.D., who later joined the staff and also shares a practice with his father.

The bustling economic climate, spurred by the steel mills in the earlier days, likewise contributed to the hospital’s growth.

“There was a good industrial base in Northwest Indiana that made practicing medicine very stable from a financial aspect,” Dr. Unni recalled.

The following decades have brought numerous advancements in health care and the way it is practiced – some of it positive, some of it seeing growing pains.
“The advent of da Vinci robotic surgery has brought big changes to urology services. These days, 80 percent of prostate cancer surgeries are done with it. The surgery is less invasive and painful, there is less bleeding and in general, faster recovery. Many procedures are done as outpatients – patient satisfaction with treatment is much higher,” he noted.

He also cited advancements in laser surgery for providing similar outcomes.
The overall health care environment has evolved into a challenging one of increased competition with “a lot of pressure to minimize costs,” Dr. Unni said.
“Insurance companies are seeking to reduce costs and patients complain costs are increasing too fast. There is pressure from industry and the government and health care dollars are shrinking,” he added.

The doctor-patient relationship also has evolved along with technology, with physicians often needing to spend more time explaining test results.

“With the Internet, people are gaining more knowledge of their bodies and sometimes becoming more demanding, wanting more CAT scans, MRIs, etc., and insurance companies resist expensive tests. The use of electronic medical records also takes more time, which can mean seeing fewer patients. It also has cut down on eye contact during visits, as we record the information on the computer, which sometimes makes them uncomfortable,” Dr. Unni said.

But he believes that process is improving and will more so, in time.

Dr. Unni said he has no plans to retire, as long as his health permits, and no plans to leave Franciscan St. Anthony Health.

“I still look forward to my patients and seeing them happy with their treatment makes me very happy. The positive feedback keeps me going. I also enjoy the friendly atmosphere here and in the community (he lives a few blocks from the hospital) and the camaraderie with the other physicians and nurses,” he said.

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Progress continues in Dyer on Emergency Department and surgical and lab renovations

Significant progress has been made toward completion of $11 million Emergency Department, laboratory and surgical unit projects that began last October at Franciscan St. Margaret Health – Dyer and are scheduled for completion in December.

“The first phase of the ED project is complete, with the opening a new, exclusive behavioral health consultation suite and the freeing up of space to build new medical treatment space,” said Dan Ratko, hospital project manager of construction.

The next phase will include a building addition that will increase available space by approximately 25 percent, as well as the creation of seven large exam rooms and three advanced trauma bays. These are expected to be open by the end of summer, he added.

“The goal is to create a more efficient space for caregivers to see patients,” Ratko said.

“An improved nurse and physician work station, with direct line of site and upgraded monitors connected to all care rooms, is an important part of this renovation.” In addition to technological and physical improvements, a five-bed observation suite and cardiac stress lab will be housed in the department to provide more convenient and faster patient care. A “results-holding” area in the triage space will be used to help make rooms available to see patients more quickly.

“At our recent construction open house, physicians and staff were able to get a sneak preview of our upcoming OR room, which is under construction. This 720-square-foot operating suite will include integration technology that can be used with the da Vinci robot surgical system, allowing easier configuration and quicker reconfiguration between cases,” Ratko said.

That construction also is expected to be completed in late summer. In addition to the operating space, new pre-admission testing exam rooms are being built, as are larger locker rooms for male and female physicians.

“The goal of the project is to expand a comprehensive emergency center of excellence. We are remodeling and expanding the current surgical space, remodeling and improving the surgical preadmission space and expanding and improving the central sterile processing department for surgery. We also are improving the main corridor and flow to the Emergency Department on the main level,” Tom Gryzbek, hospital president, said, adding, “The new design is targeted at meeting the ever-growing population in south Lake County and to help achieve our continual growth in the emergency services and surgical services areas.”

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Will it cost our patients to participate in an ACO?

We continue our discussion of the Franciscan Alliance ACO by answering the following question:

“Will it cost our patients to participate in an ACO?”

No. Patients of Franciscan Alliance providers will not pay more through our participation in ACO programs. In fact, for our patients who have insurance coverage through their employer, their insurance plan will not change. For our patients who are covered by Medicare and are attributed to the pioneer ACO program, their benefits and rights are exactly the same.

ACO providers are organized to improve quality and keep patients healthy. If doctors and hospitals are able to control the costs of care by being more efficient and eliminating waste and redundancy, this should control the price of health insurance in the future.

Next week: “How does a clinical case coordinator benefit the patient?”

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Summer Safety: A little common sense makes a big difference

People attempting to break the type of cabin fever that plagued the area during the recent brutal winter often end up fracturing bones— or worse—in their haste to enjoy long-awaited summer warmth.


“Most of the time, these injuries result from errors in judgment, as people are lulled into a false sense of security because the weather is nice,” said Stevan Vuckovic, DO, an Emergency Department physician at Franciscan St. Anthony Health – Crown Point and medical director of the hospital’s Emergency Medical Services Academy. “We see people taking unnecessary risks.”

Oft-seen injuries, Vuckovic said, include:

Cuts and fractures, which can result from falls related to cycling, rollerblading and car accidents. “People think that because there is no snow, they don’t have to be as cautious while driving,” Vuckovic said. “Texting also causes accidents. Motorists also need to be more conscious of motorcycles and joggers—watch out for them and give them extra room.” He also sees cases of people falling off roofs while attempting repairs.

Overexposure to the sun. “We see bad sunburns because people didn’t protect themselves properly. Use appropriate sunscreens and utilize shade.”

Back yard pool mishaps. “People decide to jump or dive in from higher distances. They miscalculate and can end up breaking their necks.”

Insect bites and stings. “Most of the time, the affected area will become swollen, turn red and can feel hot to the touch—that is the body fighting off the venom and those will usually go away on their own in a week. Ice packs and Benadryl can provide relief, without needing medical attention.” A trip to the emergency room is urged for people who experience a change in voice tone, get a swollen tongue or lips or experience respiratory distress. “Those can be life threatening cases,” Vuckovic warned.

Careless use of fireworks. “Leave those to the pros. Even an innocuous firework can cause serious burns and eye injuries.”

But not all injuries require a trip to a hospital emergency room.

“Our Franciscan ExpressCare (non-emergency) locations can treat bumps and bruises, fevers and colds, and sprains and strains,” Vuckovic said. “People should go to the hospital in cases where a limb is pointing in the wrong direction, or there is an open wound with a broken bone, or more obviously serious cases.”

Vuckovic also urges parents to be especially aware of what their young children are doing outdoors. “We see accidental drowning, or kids being hit by cars. Parents need to keep a watchful eye on them.

“Summer and the outdoors are meant for having fun, but use common sense to keep you out of the emergency department, so you can enjoy more of the summer. It’s no fun to spend six weeks in a cast.”

This article appeared in the Summer 2014 edition of the Franciscan Focus magazine. Franciscan Focus is available in an online digital edition, and for iOS and Android mobile devices.

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Franciscan St. Anthony Health offers baby-sitting class

MICHIGAN CITY | Franciscan St. Anthony Health-Michigan City will offer its next Safe Sitter baby-sitting course from 9 a.m. to 4 p.m. July 29.

Participants aged 11 through 13 will learn safe child care skills, basic first-aid and child nurturing techniques. They should meet in the hospital lobby and will be escorted to the classroom in St. Francis Hall, located on the lower level.

Fee is $35 and registration is required by calling 1-800-931-3322. The hospital is located at 301 W. Homer St.


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