LBJ TACKLES NCDS HEAD-ON WITH A “WAKE UP CALL” FOR PATIENTS
LBJ Medical Center officially launched yesterday the Care Management Service program, which is intended to improve the quality of life for those patients with Non-Communicable Diseases, or NCDs, and to reduce the mortality and morbidity rates associated with those conditions.
LBJ board chairman Moananu Va was accompanied at the launch, which included a news conference, by hospital chief executive officer Mike Gerstenberger, Care Management clinical director Taulapapa Dr. Anoiamoa Anesi and senior staff of the new division for the medical center. Also on the newly assigned medical team is Dr. Bethel Muasau-Howard.
Moananu calls the program a “wake up call” for patients with NCDs to comply with their physicians directions in areas such as keeping appointments and making sure their medication is taken as directed. He said many patients wait until their condition gets worse before returning to the hospital for medical attention.
Calling it an exciting day at LBJ, Gerstenberger added that “care management is a proven tool that is being used widely on the mainland to improve patient outcomes.”
“As we look at the data in American Samoa for NCDs, the numbers are moving in the wrong direction,” said Gerstenberger, who pointed out that for the last couple of years “we’ve had a very active coalition representing a wide variety of health care providers, educators, community leaders, [church] pastors, government leaders, all working hard” by looking at avenues the coalition can use in an attempt to turn those high numbers around.
“But to date, the numbers really have not moved in the right direction. If anything, it’s getting worse, not better.” he said.
“So about a year ago a group of care givers at LBJ got together and decided we needed to try something different, and we felt so strongly about this initiative that we are devoting some of our very best assets to this.” He added, “ And the only assets that we have at LBJ are our people.”
He said LBJ is dedicating two of its best nurse leaders— RN Annette Zodiacal and RN Aolele Taafua (who are also case managers)—along with Taulapapa, the former chief medical officer and an experienced physician to head up this new program and “tackle this problem”.
“It’s really important to the community that we figure out all of the approaches that will help us get a handle on the problems of hypertension, diabetes, obesity, and heart disease,” he said, noting that the toll these NCDs are taking on families and on the economy “is just obscene — and we need to do something different together.”
“So we’re excited... to be launching this program, that will certainly evolve as we learn more about what we’re doing and how patients are responding. We look forward to working with the community, he said and thanked the news media for getting the message out on this program, making it highly visible “so that a year from now we can sit down... and report improvements in patient outcomes, which is our goal.”
Muasau-Howard said LBJ is “launching this ambitious service/program... to combat the scourge... of NCDs which has hit epidemic levels in American Samoa.”
She said records have been showing that there are a lot of non-compliant patients. These records show lack of follow up with physicians, not picking up medication which is still pending in the hospital and laboratory tests not being done.
She explains that the program’s mission is to provide a “comprehensive coordinated outpatient care service” to a targeted group of patients, who have:
• complex chronic medical problems,
• a combination of several NCDs,
• high risk behavioral life styles — such as smoking, poor exercise habits,
• history of non compliance with appointments,
• non-compliance with laboratory testing and picking up medication.
“The major goal of the care management services is to affect a decrease in morbidity and mortality in the targeted group of patients by slowing or reducing the progression of the disease through better management of outpatient care,” she pointed out.
“A major part of the service is education provided to improve medical knowledge and insight of the patient into his/her condition, as well as the family caregivers,” she said.
Patients can be referred for consultation:
• by primary care physician from units/wards before discharge
• by the primary care physician from outpatient clinics
Patients identified from data with a history of missed appointments, missed laboratory testing and pending medications will be contacted, and patients may also call in for consultation.
She emphasized that the primary care physician is responsible for the clinical medical care of the patient including medications, investigations and clinical consultations.
The care manager provides the ongoing support, direct supervision and monitoring of the patient's compliance with appointments, medications, laboratory testing and lifestyle modifications, she added.
The program office is located in the Internal Medicine Outpatient Clinic and will be open Monday to Friday 8a.m. to 4p.m. Phone contact: 633-1222 Ext: 550, 551 and 552.
More from the news conference in Monday’s edition. The Samoan version of this story will be in tomorrow’s edition of To’asavili.