American Hospice: Promise of Comfort
Hospice Care
Written by Amanda Gaines   
Monday, 31 December 2007
American Hospice: Promise of Comfort - American Executive - RedCoat Publishing
Jeff Preuss explains how this hospice provider ensures its patients and their families receive compassionate palliative care.
It takes more than one nurse and pain medication to manage the grief a family experiences as their loved one goes through the end of life stages. No company understands this better than Florida-based American Hospice.

American Hospice: Promise of Comfort - American Executive - RedCoat Publishing
Jeff Preuss, CEO
From its founding 25 years ago to its current position as the second largest privately owned hospice provider in the country, American Hospice’s strategy has remained the same: deliver care consistent with the goal of hospice by enabling patients to spend their final days in the comfort of their own homes. And when that isn’t possible, have the tools to ensure patient and family comfort.

“We differentiate ourselves through technology, disease-specific programs, enhanced service levels, and being the highest quality provider we can by being available as often as the families and patients need,” said Jeff Preuss, CEO. “Whether it’s the active dying process or a time of real change in the patient’s prognosis, we can deliver the appropriate level of care.”

History and formation
The history of American Hospice goes back to the very start of the industry in the US. The company’s president is credited as a co-founder of the movement that led to what many believe was the first hospice management company in the country in the early 1990s. In time, Ameri-can Hospice managed roughly 30 hospices that were owned by other healthcare systems and providers.

Throughout the next decade, the company began extracting itself from management agreements to focus on the hospices it owned. “Little capital was available for hospices in the early ’90s,” Preuss said. “Our formative hospices were in strategic locations and simply where we had access to small amounts of capital.”

Today, the company operates hospices across five states and often under local names, such as Hospice of New Jersey, Hospice of Virginia, Hospice of Arizona, Frontier Hospice in Oklahoma, and Embracing Hospice in Georgia. As it grew to its current size, Preuss led an effort to buy out each hospice’s shareholders and consolidated operations under common ownership, American Hospice Management Holdings.

Because the hospice industry was, and still is, fairly new and what Preuss calls a cottage industry—one in which the average hospice serves less than 40 patients per day—the executive team believed the financial restructuring and consolidation gave the company a much better platform to lead the industry. “Our goal was also to remain a private company and pay attention to longer-term investments and planning that make for a clinically sound and service oriented organization,” said Preuss.

Technology enhancement
Part of that long-term vision was American Hospice’s three-plus-year, multi-million-dollar technology initiative to evolve its IT capabilities from billing and accounting to include an EMR and CRM system to move provider relations, patient admission, and care documentation to a paperless platform. Although the company did experience some productivity improvements, according to Preuss, that wasn’t the point.

“As with most projects, you bank on what you believe will happen and hope more comes out of it,” he said. “We saw these IT improvements begin to benefit our employees.”

Caregivers no longer have to haul paper patient records in their cars to and from the office to their homes, and they have noticed. In an industry with a turnover rate in the mid-30th percentile, American Hospice’s turnover rate is in the low 20s, “if not the high teens,” Preuss said. “It also enhanced our employees’ ability to access clinical data and medical records, which is a huge service boost.”

Typical hospice patients are very sick, and, historically, if a patient had to call an on-call nurse that didn’t have access to a patient record or had to go into one of the company’s inpatient units, a series of phone calls and faxes would ensue. Now, employees have immediate online access to a patient’s history, medication, and diagnosis-related plan of care.

The company’s IT investment also brought greater protection of its assets, including knowledge about its referral base. As competition in the hospice sector grows, the importance of monitoring the contact patterns of provider relations staff or a caregiver who resigns is crucial. By implementing a strong CRM system, American Hospice can see with whom that employee dealt and ensure continuity in call patterns and service.

Leader in the industry
American Hospice serves more than 10,000 patients per year and has, in the past three years, doubled in size through organic growth and acquisition. As it aggregates data about disease-specific protocols and service, the company’s IT infrastructure will be a significant tool in learning how to best manage pain, as well as how to assist families during the various stages of acuity.
“We can individualize each plan of care much better than if we didn’t have that history,” said Preuss. “We’re taking this knowledge to market, both as a way to better service our patients and as a way to manage scheduling patterns through acuity-based staffing, which is a long-term goal and something we’d like to improve upon.”

Consequently, to maintain its low turnover rate, as well as to attract caregivers looking to grow with the industry, American Hospice developed a leadership academy as part of a national training infrastructure for its clinical and provider relations teams, as well as the hospice leadership. The annual classes teach management principles and compliance along with labor and clinical resource management.

“We believe this training will bring higher retention, better quality service, and more job satisfaction as career paths develop for our caregivers. The passion and dedication of our caregivers, coupled with management hiring and development practices characteristic of a much more mature healthcare sector, are two factors that make us a leader in the hospice industry.”
 
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