Akron General Tackles Health Inequities
Education. Housing. Transportation.
What do these have to do with healthcare?
Studies have shown that 80% of health outcomes are affected by environmental factors that impact medical care, including financial stability, nutrition, community support and access to care, as well as education, housing and transportation.
The impact of poverty on people in neighborhoods surrounding Cleveland Clinic Akron General is stark. Recent census tract data for communities near Akron General along West Market Street shows that within two miles, life expectancy falls from 81 years to 65 years as household income decreases and proximity to downtown Akron increases. The pandemic exacerbated existing racial and socioeconomic health disparities – casting a spotlight on the inordinate toll of diseases on poor and minority communities.
Commitment to Improvement
Brian Harte, MD, President of Cleveland Clinic Akron General, is committed to improving healthcare for the most vulnerable patients in these communities. As part of Akron General’s Neighbor to Neighbor initiative, he’s instituted a new program, the Readmission Reduction Project, to tackle these barriers head-on, with a goal of reducing repeated hospitalizations.
The Readmissions Reduction Project is led by Julie Imani, an Advanced Practice Registered Nurse (APRN) who will focus on patients’ transitions of care from the hospital to home or a skilled nursing facility and follow patients’ long term outcomes. Before discharge, she will meet individually with each patient, to establish a relationship and understand how best to assist them with community resources.
Julie will connect patients with social service providers to address housing, transportation, food insecurity and other environmental indicators, and help patients access Akron General’s Patient Assistance Fund if they cannot afford their medication. Patients will be discharged with home medical devices if needed, such as blood pressure monitors or diabetes test strips. Once the patient is home, Julie will follow up with them to track outcomes or adjust medication as needed.
Connecting Patients with Resources
The Readmissions Reduction Project grew out of a pilot program that was conducted in 2019. An interdisciplinary team of Akron General caregivers evaluated 68 patients to determine why they were readmitted to the hospital and develop a plan to address the issues. The team found that many patients struggled with environmental factors. Patients that were seen by the readmission team had a 32% reduction in 30-day readmissions.
Julie led the interdisciplinary team involved in the pilot study. “One patient had been in the hospital 4 times in 5 months due to recurrent urinary tract infections and sepsis,” she says, and he hadn’t been coming to his urology follow up appointments.
After interviewing him, Julie learned that he had problems with transportation, food insecurity, lack of social supports – in other words, he lived alone and didn’t have family to help him. Before he was discharged, she worked with him to activate assistance covered by Medicaid, such as Akron’s Metro Scat program for transportation needs, a nutritional supplement for malnutrition, attending an adult day program and arranging a visiting physician to come to his home. The outcome? The patient was not readmitted for nearly two years.
“No one wants to be readmitted”
The program will focus on providing assistance to patients living in six ZIP codes that surround the hospital, which accounted for more than 2,600 discharges in 2021. Additional details will be applied to known risk factors for readmission, including age, sex, cognitive impairment and chronic illness. The goal is to reduce readmissions for these patients and improve their quality of life through referrals and resources to address known barriers to health.
Funds raised through the Neighbor to Neighbor philanthropy campaign have supported the first year of this initiative. However, an additional $500,000 is needed to help fund the three-year project.
“No one wants to be readmitted to the hospital. Akron General’s goal is for our neighbors to heal and flourish,” Dr. Harte says. “This new readmissions initiative will help achieve that goal by linking the most vulnerable patients with extra support and resources to improve health long-term.
How You Can Help
Your support is a vital part of our Readmission Reduction Project. A donation to Akron General’s Neighbor to Neighbor campaign helps reduce health disparities and make our community stronger. Make a gift here.
Hyundai Grant Propels Research Forward
A Hyundai Hope on Wheels grant is providing bridge funding for pediatric cancer research that may help adult leukemia patients.
Seth Corey, MD, MPH, was studying the genetic factors that transform Severe Congenital Neutropenia (SCN), a rare type of bone marrow failure syndrome, into more common syndromes in adults. His research had hit a snag: Dr. Corey couldn't develop his hypothesis by studying mice because mice do not have the most commonly involved gene in this childhood malignancy.
“It would be a great advance if we could develop an another model to study what happens when the mutations occur,” he says. “We have a bold hypothesis about this genetic mutation, and the Hyundai Hope on Wheels grant permits us to study this further and get more data to develop our hypothesis more. Then we hope to take it to NIH (National Institutes of Health), where the funding is very competitive.”
Supporting Pediatric Cancer Research
Hyundai Hope on Wheels began in 1998 as a way to raise awareness and fund research for childhood cancer, through a donation from every new vehicle sold at a U.S. Hyundai dealership. The nonprofit has awarded more than 1,000 research grants, and the $300,000 grant to Dr. Corey’s work is the largest Hyundai Hope on Wheels has given to Cleveland Clinic.
“Dr. Corey’s research is groundbreaking in that it changes the standard perspective scientists and clinicians use when studying Severe Congenital Neutropenia,” says Rabi Hanna, MD, Chair of the Cleveland Clinic Pediatric Hematology-Oncology Department and the Jerome and Lee Burkons Endowed Research Chair in Oncology.
This pediatric disease is a model for the more common myelodysplastic syndromes in adults. Dr. Hanna says, “Success of Dr. Corey’s proposal will provide a long-sought experimental model for SCN and its transformation to myelodysplastic syndromes or acute myeloid leukemia, thereby leading to greatly improved treatment options for both.”
In his role as a clinician, Dr. Corey is also monitoring half a dozen patients he has seen with the rare Severe Congenital Neutropenia, which affects one in 250,000 people. But it can take 20 years for the mutation to cause leukemia and other malignancies to appear.
“These are what I call experiments of nature, meaning: these are rare pediatric diseases that are genetically defined and that can give us insight to both fundamental processes within a cell as well as convey insights into the far more common adult disorder,” Dr. Corey says.