Queens Boulevard Partners with North Shore-LIJ to Improve Care Continuum for Patients

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Dr. Jonathan Mawere has been with Queens Boulevard Extended Care Facility (QBECF) in Woodside, N.Y., in various capacities since 1999.

Founded in 1995, QBECF is a 280-bed, state-of-the-art nursing facility that specializes in sub-acute rehabilitation. Its services include 24-hour skilled nursing care; physical, occupational, and speech therapy; wound management; and hospice care services.

From the time Mawere arrived at the organization, achieving better care coordination between QBECF and local hospitals in the North Shore-LIJ Health System has been an evolving initiative. The initiative reached its apex in 2009 when QBECF and North Shore-LIJ signed a clinical affiliation agreement that officially made them partners in providing care.

Since its signing, the affiliation has produced outstanding results, but above all else, it has ensured that patients who leave a North Shore-LIJ hospital are guaranteed a smooth transition into QBECF.

A partnership of opportunities and outcomes

The advantages of partnering with a large system are numerous, Mawere said, especially when the system is continuously growing. Currently, North Shore-LIJ has 17 hospitals with more being added every year.

North Shore-LIJ’s expansion and acquisition strategy broadens the niche QBECF occupies on the continuum of care by expanding the population served by the facility. It has also improved bidirectional communication between the organizations.

“You don’t want a patient who is transitioning to either the hospital or a skilled nursing care facility to have a delay in care as a result of communication problems,” Mawere said. “This can eclipse timely clinical decision-making, which is essential in patient care.”

Improved communication led to improved care management as the collaborative bond between the organizations was strengthened. In fact, Mawere said they embarked on several projects together in order to limit unnecessary readmissions of patients.

“We focused on specific chronic diseases and advanced illnesses that typically would cause patients to end up in the hospital, such as pneumonia, congestive heart failure, diabetes, and COPD, with the goal of improving the way we manage conditions in both the hospital and our skilled nursing care environment.”

Educational opportunities were also opened up for providers both within QBECF and the North Shore-LIJ hospitals. Furthermore, alignment allows medical students and residents to rotate in both care settings, broadening their exposure and experience with the geriatric population.

A partnership of trust and respect

Mawere said both organizations entered into the affiliation agreement fully knowledgeable of each other’s advantages, with the goal of leveraging their strengths to deliver the best outcomes for the patients.

North Shore-LIJ chose QBECF because of its reputation for excellence. The facility’s five-star rating, which it first received when the rating system was implemented by CMS, has been maintained even after CMS toughened the standards and 1200 facilities lost their rating status.

Additionally, QBECF has been included annually on U.S. News & World Report’s Honor Roll of America’s Best Nursing Homes since the publication began rating facilities.

The affiliation was obvious for QBECF given North Shore-LIJ’s progressive strategic vision and its status as the largest healthcare system in the northeastern United States.

“With our goals and visions being so similar, the affiliation between North Shore and Queens Boulevard Extended Care was an easy choice to make,” Mawere said.

A partnership of survival and stability

As healthcare organizations transition to the value-based, accountable-care, and bundled-payment models, partnerships and affiliations are paramount to a facility’s success, Mawere said.

“In today’s healthcare arena, the idea that you can survive as an island is antiquated and will not work. You need partnerships. You need affiliations. You need to work with other organizations.”

He believes the only way to achieve the best metrics with bundled payments is by collaborating with partners a leader can trust.

I would advise every leader in healthcare to find worthy affiliates or partners because no healthcare organization can exist on its own,” Mawere said. “You will not survive any other way. You have to join up with somebody else.”

QBECF’s most recent initiatives have been designed to enhance its value as a collaborative partner. Mawere said the organization is currently integrating an outpatient rehab program into its service line as part of an effort to diversify its portfolio of services. A dialysis unit is in the near future, he added, which will help solve accessibility problems for patients in Queens, Brooklyn, and Manhattan who are seeking dialysis services.

“These services are needed in the community and would improve our ability to work with other organizations,” Mawere said.

QBECF is also working toward unifying its EMR. Right now, the platform is fragmented. The goal is full integration.

“The way things are moving, the future of healthcare is an environment of collaboration among providers, and with that collaboration comes better efficiency and better communication,” Mawere said. “This will lead to better and more effective patient care.”

by Pete Fernbaugh

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