Liberating Patients Off Ventilators
CEO Special Care Providers
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Yes, we are absolutely the best. What we do, weaning patients off the ventilator is our main goal. That's the entire focus. We have a multidisciplinary high touch approach, early ambulation, early mobility as part of our success.
Welcome to Medvale, a community helping health care innovators make a difference. Through Medvale radio we broadcast thoughtful conversations of how Medvalistas and our friends are helping individuals get healthy. This is Jim Trounson, your host. And my guest today is Sam Nimah, spelled NIMAH. Sam is CEO of Special Care Providers. I've known Sam for years through YPO the Young President's Organization. We are here at a YPO meeting at the Harvard Medical School where I caught up with Sam to share with us the amazing success he is having with liberating patients off ventilators and into more independent lifestyles.
Well, Jim, thank you for having me today. I eally appreciate spending all of their time talking with you. You know, the notion of making the world a healthier place is it has got a lot of different tracks. And one of the things that's very popular these days is the term population health. Everyone talks about how to how to keep people out of the hospital and keep them healthy. And that is a that's a great mission. However, we have an aging population and people do get sick. And so we attack from a different angle. Our approach is those patients who are on the other end of the spectrum, the sickest patients in the hospital. How do we get them better and out of the hospital? Because in your typical Parado principle, 20 percent of the population costs 80 percent of the expense. Right. So while we're keeping everybody healthier, as many people healthy as we can, those who are really sick, they cost an incredible amount of labor and pharma and nutrition and everything. So our goal is to get those patients who are on a ventilator. So in a hospital, you're going to have multiple Heisey use. And in those ICUs, you may have one trache vent patient. So in your neuro ICU or your CV, ICU or your post surgical or medical ICU, you may have one trache vent patient, maybe two, but it's certainly not going to be the whole population of the unit. And those patients don't always rehabilitate well in the ICU setting.
So what we do is we consolidate those patients into one of our special care units. That's the name of our of our program. But we do it in partnership with the hospital. So we use the hospitals, physicians who come to our unit and we provide all of the ancillary care. So respiratory therapy, nursing PTO, OT, speech therapy. And we, in fact, even do our own case management. And those are your employees? They are our employees yes. And so we we provide a multidisciplinary approach, a respiraory therapist driven protocol, meeting protocol. And physicians, once they learn, truly understand what we do and how we do it. They absolutely love it. In fact, sometimes we have trouble getting physicians to leave our unit, sometimes because they enjoy being there so much and they see the results. So this patient population doesn't have an appropriate place in our health care system. I'll give you an example. Hospitals wean patients off the ventilator somewhere in the neighborhood of about 60 percent of the time. LTCs, long term acute care hospitals, or as I like to call them, long term storage, that they wean less than 50 percent of the time on average. There isn't a great solution until we created our solution. So other people invented the solution. But when I was looking for something to acquire, I absolutely fell in love with the company and I felt like I could improve upon it.
And that's what we've done, is specializing world seems like that's what you've done.
Yeah, we are absolutely the best at what we do. weaning patients off the ventilator is our main goal. It's the that's the entire focus. We have a multidisciplinary high touch approach. Early ambulation, early mobility is part of our success. But it's not all of it. It's the notion that not every good idea comes from me. I don't invent every good idea. We have a quarterly meetings, but then within that we have additional meetings to brainstorm new ideas. Let me give you a couple quick examples. We were having a brainstorming session and one of our licensed physical therapy assistants said, well, you know, there's a there's a problem is that, you know, we want early mobility, but some of our patients can't ambulate because they're, you know, acquired in. And so what if we could get them to ambulate virtually? Would that help? And so I didn't know the answer to that. But here's what I did. We went out and bought virtual reality headsets, and now we utilize them in the acute environment to help those patients who can't ambulate virtually ambulate. And therefore, they're motivated to start moving something. Well, it's a pretty high tech approach. It is. But in addition to that, once we started researching virtual reality, we found out that there's some folks out there that are some hospitals out there that are utilizing it for management of anxiety.
And so they're avoiding a drug with a completely non-invasive headset, which does no harm to anyone. So that's pretty exciting stuff. Another example is we were in another brainstorming session and one of our physical therapists said, well, you know, there's been a study that shows that patients who ambulate after they've been discharged trache them. Patients who have been weaned and ambulate after they've been discharged have a reduced likelihood of readmission. So we started talking about that and we said, well, how can we motivate people to ambulate? We went out and we bought pedometers. On exiting or as we call it, graduating from the special care unit, we give each one of our patients a pedometer so they can measure their steps. We tell them recorded. Call us. Let us know how you're doing. So that now they are again motivated will help everybody. Maybe not. But if I can get one patient to use that pedometer and it helps them from readmitting to the hospital, then that's a win for your changing patient behaviors. We are definitely changing patient behaviors. But in addition to that, we're changing lives. One of the things I'm most proud of is not necessarily our impact on patients.
Mind you, we have some really spectacular outcomes. But, Jim, I mentioned to you a young lady by the name of Olivia and I sent you her article. She was a she was found nonresponsive in her dorm room in Tuscaloosa at the University of Alabama, who came to us. And we were able to give her her life back. But it was her strength that we drew upon. Know we can't create strength in a person. All we can do is bring it out. But what was most special to me, what really, really gets me up in the morning is Olivia just started her senior year of college and she came back to the University of Alabama. Her and her parents flew down from Long Island to move her into her apartment in which, you know, they stopped by to have lunch with us for a day and to see how a patient care technician run up to Olivia and give her a hug that it lasted so long, I wasn't sure she was going to let her go. But but just sitting with that family and our caregivers and seeing the impact that Olivia has had on our employees. It just it warms your heart. It makes you feel good about what you do.
Well, Sam, I can tell how touched you are by that. Thank you for sharing that story.
Life on a ventilator is as bad as you can imagine. Which is why we love helping them get off.
And how do you do that? What's the magic of what your company does other than doing it a lot? Getting very good at it.
Or we're constantly looking at new ways to do it. Let me give you another quick example. I ran into a friend of mine that was telling me about what they're doing in the area of opioid reduction and so opioids. Block the signal from the pain, point your body to the brain. That's how they operate. Unfortunately, here you also get addicted to them, which is a real big downside. Their technology has taken a slightly different approach. So instead of blocking the pain signals to the brain, they are overriding it with electrical stimulation. Completely. Again, non-invasive, non addictive, avoids opioids and creates a pain free environment. So what we've done is we're starting to use that on our patients as well to curb and reduce and eliminate opioid usage on our unit. In addition to that, it also allows for extended rehabilitation. So we see this as being another big opportunity for us to reduce length of stay.
Our patient population.
So it sounds like you're getting good ideas from other people. I joke about myself that I've never had an original thought. But I've got some pretty creative friends.
Yeah. Yeah. You and I are in the same boat there. I've, I can tell you most of my ideas are stolen from other people and I try to improve upon them. But really I find brainstorming and sharing ideas with each other as is the way to go.
Now in terms of value propositions, Sam, I can imagine how helpful you are to an individual patient who's living on a ventilator. How about to the hospital CEO? What value do you bring to these hospitals that you are in which you have a unit?
Yeah, we could. Great question. We are living in a world that is increasingly capitated. And so if you're a revenue from a hospital perspective is fixed and you can reduce your costs, then your margin improves. Now, if you take our patient population, they are the longest length of stay in the hospital. So you can take that longest length of stay and reduce it. That is a huge boon.
When when I start talking about improving outcomes and I expect the hospital to ask the question, I expect them to ask, well, what will it do for our financial statements? But if that's the only thing they care about. Frankly, that's the wrong partner for me. OK. So one of the things that we've had to do is we've had to walk away from some customers. We've had to walk away from some hospitals that really don't put the patient first. We we will make money for the hospital, but it's not the primary goal. The primary goal is patient outcomes. So we are focusing on partnering with the Right. hospitals.
Well, that's fascinating to walk away from opportunities as you're building your company can be hard, hard to do.
It's not a real opportunity. Now, Jim, I. Let me tell you, if they are not interested first and foremost in the patient outcome, it's not the right opportunity for us.
Well, Sam, this has been great. I'm enthused about this. I'm sure our listeners are as well. And I'm sure some of them are going to want to get a hold of you. How best could they do that?
Well, the best way is to go to our Web site. It's reducereadmissions.com
reducereadmissionsnow.com. Now, they could get a hold of you through your website. Yes. Then, yes. Well, I predicted they will. This has been a very stimulating chat we've had, Sam. And thank you for making the world healthier.
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Sam Nimah helps the sickest and most expensive patients get off ventilators and leave the hospital earlier. Lives are improved and hospitals do better financially through lower lengths of stay and reduced re-admissions. Special Care Providers runs intensive care units for hospitals; and you’ll be intrigued by how Sam picks their clients. Their team ideation works to come up with innovations to leverage virtual reality and opioid options to improve outcomes. You’ll be inspired by their stories.s.
what you'll learn:
- Getting patients off ventilators earlier is a good thing.
- Life on a ventilator is not a good life for a patient.
- In our capitated world, hospitals suffer financially with the long length of stays and re-admissions of ventilator patients, which Special Care Providers reduce.
- Special Care Providers takes over and staffs hospital’s care units to achieve early ambulation, early mobility using a multidisciplinary and high tech approaches--such as virtual reality and pedometers.
- Sam picks his hospital clients more on their interest in improving patient outcomes than in how Special Care Providers can improve their bottom lines—which it also does.
- You’ll enjoy the story of how one patient got her life back because of this company.
- Sam appreciates that so many of the good ideas that they implement come from his employees during brainstorming sessions.