Upham's Corner Online

VNA Boston Celebrates 125th Anniversary
Reception at Grove Hall Branch Library

Posted: May 26, 2011     Nancy J Conrad

VNA Boston
On May 26, 2011 the Visting Nurses Association of Boston held a reception at the Grove Hall Branch Library.  This is one of many opportunities throughout 2011 for the VNA Boston to mark its 125th anniversary.  

They began planning their year-long celebration in September 2010.  "We were trying to figure out a way how to get back into the community," said Janice Sullivan, External Affairs. 

"How do we balance celebrating our history with celebrating the future of home healthcare?"  A traveling exhibit featuring a timeline seemed the perfect way to tell their story.  

JS:  "Our history begins in 1886 with support to the community and involvement in public health crises - influenza in 1918, the molasses problem in the North end when that tipped over.  We were there at the Coconut Grove fire and provided a lot of assistance.  During the AIDS crisis, we were out there taking care of patients in the community.  Back then it was not a chronic disease; it was a death sentence."

The VNA Boston Traveling Exhibit started in the Statehouse in May, will visit many community locations including Boston Public Library branches, community centers, assisted living spaces and some hospitals.  The final stop is City Hall in September, then back to VNA headquarters for the end of year celebration in December.  

A schedule is available on their website:  http://www.bostonvna.org/

UC News:  If Boston-area residents use clinics for non-emergency care and hospitals for emergency care, where does the VNA fit in?  

JS: "I will tell you a story.  A VNA Boston nurse visited a patient in Quincy, a Vietnam vet, homebound with leg issues following surgery.  He was also diabetic.  She discovered that the patient could not figure out how to get the right insulin level.  When he was discharged from the hospital, the hospital staff had not yet reconciled all the different medications he was taking. "  

"Our nurse worked with the physician to straighten out his medication.  She also taught him how to do his insulin, made sure that he was eating and set up an appointment for him to see the physician in the next couple days.  She told us that had she not gotten his insulin under control, he would have gone into diabetic shock. "   

UC News:  How did the VNA nurse happen to visit him?

"We were referred to this patient by the hospital for wound care.  What we found required a lot more medical assessment and management. Hospitals are a huge referral resource for us, same with physician offices and assisted living facilities.  A visiting nurse is a traveling nurse to a ‘home' facility which could also be an assisted living facility but not a hospital or clinic." 

UC News:  How you differentiate yourself from other nursing organizations?

VNA Boston JS:  "The 125 year anniversary is one way.  More importantly, we differentiate ourselves through quality scores.  We are very proud of our quality outcomes.  They are publicly reported and in most areas we do better than state and national benchmarks.  Another area we really pride ourselves in is working in collaboration with our physician partners to keep people out of the hospital and to avoid unnecessary readmission."

UC News:  How well-known is the Visiting Nurses Association of Boston as a home healthcare provider?  How do you differentiate yourself from other private homecare providers?

"We rate ourselves as different, very different," said Reynold G. Spadoni, President & CEO, VNA Boston.  "There are private homecare companies and then there are organizations like ours that are certified."

Rey explained that the VNA Boston is made up of several companies - certified for Medicare coverage, private care and hospice care.  What differentiates each company is the payor status as defined by Medicare.  To qualify for Medicare benefit you need to be homebound and you need to have a reason to be referred, a condition that can be treated by skilled nursing and physical therapy specialists.  If you don't meet those criteria but you need nursing care, then you go to a private care company.

RS:  "We are proud to say that the first Visiting Nurse Association in the United States started right here in Boston and it has spread throughout the country. Most big cities have VNA's.  All the states have home health agencies modeled after the VNA."

Consider this:  The VNA in the greater Boston area cares for 2000 people every day.  If you look at that scope and size, you quickly realize they are comparable to most of the big hospitals.  They just don't invite patients into their four walls but rather travel into those of the patients.

UC News:  To what extent are you involved in digitized health records?

RS: "Extremely.  The home health industry was one of the first to go to electronic health records.  We do everything electronically."

The federal government has mandated a reporting standard for Medicare called Oasis.  It is a computer-based clinical documentation system.  Visiting nurses ask the patients a series of questions; they input the data; and they use the computer to chart the patient's record.  All of that is used to manage the patient and ultimately to generate an invoice to the federal government.  So it is a pretty complicated and comprehensive system. 

UC News:  What do you feel about celebrating 125 years? 

RS: "We feel both elated and excited.  There are a lot of challenges going on with the healthcare environment right now.  We are being called on to change with the times.  In organizations such as ours - we are innovators.  We helped to start this movement.  We changed along with it.  We are now being called on to try with fewer resources to do even more. "  

"Patients are getting discharged from the hospital sicker and sooner.  In the old days someone would come out of the hospital after seven days with cardiac surgery.  Now they're coming out after three days.  Their needs are substantially different.  We have to keep our nurses trained.  We have to make sure we have the latest laptops and technology. " 

UC News:  So tell me about the future, how excited you are about the future and what you see happening in the next 10 or 20 years.  

RS:  "With an aging population, there are more and more people who are going to need home health services.  Because patients are getting discharged sicker and sooner, we believe we are in a good position to do everything we can to keep people in their homes.  Home is where most people want to be - independent and with the highest quality-of-life possible. "  

"We think the demand for our services is going to be greater, particularly as the whole rest of the health system evolves into accountable care organizations.  Hospital and physician groups are going to be responsible for the health of a defined population.  So for us, we keep people home; we are a lot less expensive than a day in the hospital.  So we are excited about the fact that we believe we are going to be recognized for the role we play in healthcare. "
VNA Boston

The "accountable care organization movement" that has been around for a while but was only recently adopted and accepted by the Obama administration - part of health reform.  Basically the idea is this.  Healthcare oftentimes breaks down whenever handoffs occur moving a patient from one setting to another. A patient with a complicated discharge summary is subject to poor healthcare at the next phase of patient management for a whole variety of reasons.  "This is super expensive," he said.  "VNA's are in a position to make sure the patient recovers well, thereby improving the performance of the entire system."

"We are very proud," Rey said, "to be celebrating our 125th anniversary.  We are eager to see what the next 125 years are going to be like."

Thanks to Janice Sullivan, External Affairs, and Reynold G. Spadoni, President & CEO, Visiting Nurse Association of Boston & Affiliates, for taking the time to speak with us about their great organization.

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