Patient-centered health care.
It means that we put patients at the center of their care, giving them control over their health and their goals, with St. Luke’s experts helping to advise, coach, supervise and assist where needed.
A great example is our cardiac rehab program, which works to empower patients and help them meet their goals. Here is St. Luke’s Communications Coordinator Chereen Langrill with one patient’s inspiring journey.
- David C. Pate, M.D., J.D.
Jerry Randklev has been active all his life, but it took a heart attack to awaken his passion for exercise and to help him realize he wasn’t doing enough to keep his heart healthy.
The catalyst for Randklev’s transformation was the St. Luke’s Heart Health and Rehabilitation Center in Meridian. The program – and its energetic staff – motivated the 70-year-old Boise man to change his health habits.
“No one gets in your face and says, ‘You need a new lifestyle or you’re gonna die,’” Randklev said. “They lead by example.”
The program’s medical director, Dr. Jennifer Shalz, can often be found working out in the gym alongside patients. Dr. Shalz and other staff members teach the benefits of a Mediterranean diet and follow through by snacking on fresh, heart-healthy foods such as almonds and carrots.
The rehab center reflects St. Luke’s patient-centered approach to care: The staff works with patients to identify individual priorities and challenges, resulting in better outcomes.
There is strong evidence supporting the benefits of a cardiac rehab program like the approach being taken in Meridian. Patients who participate in a 12-week cardiac rehab program can experience up to a 45 percent decrease in risk of dying from any cause over the next 10 years, according to national statistics.
But cardiac rehab is good for patients’ financial health, too. The program helps participants maintain a healthier weight, which decreases the chances of type 2 diabetes and many cancers, conditions that can cost patients physically, emotionally and financially.
Randklev has lost 20 pounds since he began the program more than a year ago. Before he retired, he traveled frequently as a vice president at J.R. Simplot Co. He is amazed at the change in his energy level. He is a skier, and before he graduated from the rehab program, he would need to rest after a couple of runs. Those days are over.
“I can just go and go and go, like the Energizer bunny,” he said. “I don’t care if this extends my life by one more day. I just feel so much better now.”
In October 2015, Randklev was attending the Trailing of the Sheep Festival in Sun Valley. He woke up in a sweat and didn’t feel well, so he went to St. Luke’s Wood River.
“They told me I was having a heart attack,” he said.
He received a stent, but after additional tests were performed, he learned that he also had a significant blockage in the left anterior descending artery. He was scheduled for coronary artery bypass surgery in April 2016.
He couldn’t have the surgery right away because he was taking a medication that made it difficult for his blood to clot. While Randklev waited for his surgery, he decided to enroll in the rehab program to improve his fitness and ease his recovery. The plan worked well for him, and within four weeks of his surgery, he was back at the Meridian facility to resume his exercise routine.
Randklev completed a highly supervised second phase of the program and when he “graduated,” he decided to continue on (Graduates have the option to continue exercising at the center by paying a fee comparable to a monthly gym membership for a lightly supervised third phase of the program.).
“Initially, it’s something you have to do,” Randklev said. “By the time people get to phase three, they’re believers. There’s a thirst for more.”
The program is filled with success stories like Randklev’s. Provider referrals are often at or near 100 percent for the program. And of those patients who are referred to the program, more than half choose to participate, according to Pat Lara, center program director.
Word of mouth among physicians and their patients has fueled the program’s popularity.
“That, coupled with the care coordination, clinical supervision and excellent outcomes we achieve, have combined to establish the program as a vital component of the overall heart program in the eyes of the physicians,” Lara said.
The program also strives to eliminate two of the greatest barriers to care: transportation and cost. Through a Valley Ride program called Rides 2 Wellness, patients can move between appointments. And the support of generous donors has made participation possible for patients who wouldn’t otherwise be able to take part because of cost barriers. In 2016, the program awarded 73 scholarships.
“Cardiologists are so invested in this program that they put up their own money to start a scholarship,” Lara said.
The scholarship program began in 2015 with an endowment of about $15,000 from St. Luke’s cardiologists. It is now one of the options in the annual employee giving campaign, and patients have also donated. Each month, about $2,000 is awarded in scholarships, and the program receives an average of $2,000 in contributions each month.
The program has received institutional support from St. Luke’s in the form of resources that give each patient the best shot at success. Randklev’s experience, Dr. Shalz said, reflects one of the program’s greatest strengths: a strong care team that includes a physician, a nurse practitioner, respiratory therapists, exercise physiologists, nurses, dieticians, physical therapists, occupational therapists, diabetic educators and social workers.
“This is vital,” Dr. Shalz said. “This team is able to individualize the program as much as possible, even though the majority of the care is done in groups.”
Randklev plans to continue exercising at the rehab facility for the foreseeable future. He enjoys the bond he has with other patients and values the encouragement and education he continues to receive from the staff.
When he described how the care team empowered him to take control over his health, he reached back to his years in business to share an analogy.
“You’re in the business of managing your health,” Randklev said. “You’re the CEO. But you’re not on your own.”
St. Luke’s heart rehab patients love to sing the program’s praises, and do so by the mailbag-full.
They frequently write Dr. Jennifer Shalz, Pat Lara and other St. Luke’s leaders and program directors to recount their success in and share gratitude for the rehabilitation program.
Here are excerpts from recent letters:
“People ask me all the time how I am doing. My response is that I am in a ‘world-class’ program that is adding years to my life. A program that is facilitated by people who amaze me every day with both their knowledge of complex issues and the personal manner in which they deliver the care we patients need.”
“I worked in hospitals for over 50 years and I can safely say that I have never seen such overwhelming adherence to the well-being of the patients.”
“I cannot adequately express just how much this entire experience has contributed to my will to live a full and robust life. There were moments after my surgery when it would have been easy just to throw in the towel and give up, but cardiac rehabilitation shook me out of that funk promptly.”
“Perhaps the most important aspect of cardiac rehab for me has been the strongly unified message of lifestyle as key to cardiac and overall health, and how to achieve that lifestyle from a well-coordinated, interdisciplinary team.”
“Under the direction of Dr. Jennifer Shalz, your heart health center is a truly amazing place. I simply cannot say enough about the quality of personnel, their attention to detail and commitment to total patient care.”
“There is no doubt that St. Luke’s saved my life on 25 November. After that, however, your health care system did so much more to make the life you saved even better.”
Chereen Langrill is a former communications coordinator for St. Luke’s Health System