Sponsored: Hollister- October 2023- The Journal of Healthcare Contracting
In today’s U.S. healthcare continuum, the right products, information, and support are critical to a successful patient journey. A successful journey not only helps patients lead a self-sufficient life, but it also has a positive impact on the health system. It can lead to less visits to the emergency department, less unplanned physician visits and less hospital readmissions.
Never is that more evident than with patients who undergo ostomy surgery. An estimated 725,000 to 1 million people are living with an ostomy or continent diversion in the U.S. and approximately 100,000 ostomy surgeries are performed each year nationwide.1
An ostomy can be temporary or permanent and living with an ostomy impacts patients both physically and psychologically. Reactions are individualized and personal. One may find it lifesaving or restoring their life, while another may find it devastating. Each adjusts in their own way.
Preoperative and postoperative education and ongoing care tips from a Wound, Ostomy and Continence (WOC) nurse or coordinator associated with a supplier-sponsored patient support program help patients during their adjustment period and along their path.
“Having that extra layer of support and connection through patient support programs reduces postsurgical trips to the emergency department,” said Aimee Frisch, a WOC nurse with Froedtert Health in Wisconsin. “These programs offer more education. I always tell my patients to reference what we send home with them, but it’s a lot of information. It can be overwhelming, so we include all contact information for these programs like website links and phone numbers they can call.”
Frisch says program coordinators also call patients to check in on them and ask about their supply levels, which also helps reduce trips to the emergency department.
“We had a problem with patients showing up to the emergency department with leaking ostomies or being out of supplies,” she said. “They would show up to get supplies because retail pharmacies don’t carry them, and a lot of patients can’t wait 24 hours.”
Connecting these patients with support programs and transition services gives them a contact who understands their situation, can answer their questions and works with them to secure supplies.
Supplies
Health systems can be limited on ostomy supplies, so patient support programs are vital to getting patients what they need on their journey.
“We give them one or two changes worth of supplies,” Frisch said. “The extra layer really helps close that gap and it’s a big gap that can make it or break it for someone with a new ostomy.”
When a patient leaves the hospital, they are fitted with what’s on formulary in the hospital’s supply chain. When they get home, they might need different supplies as their abdomens change and their diets change, according to Tammy Lichtman, assistant nurse manager for AdventHealth in Florida.
“When they use a patient support program, they have access to ostomy experts,” she said. “When we reach out to our supply partners, their programs are willing to send sample product that fits a patient’s needs specifically. Then we can start addressing the problem.”
AdventHealth’s colorectal department sees complicated cases and has access to a variety of supplies. “We need that access,” Lichtman said. “Other facilities may not see that kind of patient population.”
One size doesn’t fit all, she says, so being able to work with AdventHealth’s supply chain in outlying cases is helpful. “I know what we have on formulary, but I can also get in some specialty supply for outliers.”
The value of patient support programs
A recent cross-sectional survey on the value of patient-centered ostomy programs found that 83% of respondents did not have postsurgical ostomy-related emergency department visits, 75% did not have related unplanned physician visits and 90% did not have hospitalizations. Participants with two or more interactions were more likely to contact a program coordinator for issues of stoma care, leakage and skin care, ostomy products and accessories, and supplier issues than their single-interaction counterparts.2
“Some of the issues in a patient’s home environment are access to supplies, getting supplies covered by insurance and getting fitted properly,” Lichtman said.
She says if the fit is incorrect, patients can go through all of their supplies, ending in a bad skin breakdown with no supplies left. This can result in a visit to the emergency department.
“They can end up there either from a clinical standpoint or without supplies. And from a psychological standpoint, emergency departments can see patients in extreme distress,” Lichtman said.
Relationships with patient support programs can be lifesavers because there is someone to talk to, says Lichtman. Patients who are interactive users are more likely to have those relationships and utilize the transition services the way they are meant to be used by patients.
Support programs can provide sampling and guidance to find products that best fit patients. The right product and fit, and using the same manufacturer’s product throughout the patient journey, helps provide patients the support they need to live a better life.
“They reduce a lot of the anxiety and fear felt by patients,” Lichtman said. “Not all communities have access to an ostomy nurse and a lot of surgeons get anxious calls from patients after surgery. That can be relieved through a support program that answers questions and identifies issues before they become problems.”
“Patients feel like they are known in a support program,” Frisch added. “They usually talk to the same person, so they don’t have to rehash their story. If not, there’s a running casefile.”
Frisch says the support programs also patch patients into their communities where they need to be connected because, for a lot of them, the only person they know with an ostomy is themselves.
“Almost all of the patients we connect with the programs are really satisfied,” she said. “Our outpatient clinic follows them at their four-week, six-week and three-month check ins, and these programs help our busy outpatient clinics. If patients can’t get into the clinic soon enough, they still have the support they need from these programs.”
Article sponsored by Hollister Incorporated.
1 Ostomy and Continent Diversion Patient Bill of Rights: Research Validation of Standards of Care
2 McNichol, Laurie; Markiewicz, Anna; Goldstine, Jimena; Nichols, Thom R. A Cross-Sectional Survey Reporting on the Value of Patient-Centered Ostomy Programs: A Smooth Transition After Ostomy Surgery. Journal of Wound, Ostomy and Continence Nursing: September/October 2022 – Volume 49 – Issue 5 – p 449-454