Improving ‘continuum of care’ adds up to challenge for new vice president

May 5th, 2017

Part 3 of 3-part series

Billie Kester loved math throughout school and even served as a math tutor. At one point in her life she thought she might pursue a career in accounting. The untimely death of her father at the young age of 42, however, changed her focus and inspired her healthcare career.

Billie Kester, VP Continuum of Care

“I watched my father, who had been diagnosed with Type 1 diabetes as a teen, suffer through kidney failure, an organ transplant and ultimately succumb to cryptococcal meningitis as a result of a suppressed immune system,” says Kester. In watching the many interactions he had with nurses in his health journey, she said she was struck “by the amount of impact one could have on another’s life through educating them about their disease process and how to properly care for themselves – and I knew I wanted to be able to make a difference.”

As Reid Health’s new Vice President of Continuum of Care, Kester has stepped into a key role for having an impact on the health and well-being of many, she believes. “This is a relatively new concept in the world of health care,” she said, referencing her title and another phrase that has become a driver for how the delivery of health care nationally is changing – “population health management.”

Craig Kinyon, Reid Health President/CEO, said Kester will lead continuing efforts to increase partnerships, information sharing and improved care for patients “across the continuum.” He noted that Kester helped developed her new position after serving as Director of Continuum of Care, reporting to Kay Cartwright. Cartwright retires in May from her dual role as Chief Nursing Officer and Vice President/Continuum of Care, with Kester taking on one of the roles from her former boss and mentor.

Kester was a natural choice for the job after serving as Director of Continuum of Care for the past four years. The job has included daily oversight of care management programs, inpatient case management and discharge planning, overseeing the transition coaching program, Community Benefit operations and building partnerships such as a regional collaborative for nursing home quality improvement, Kinyon said.  “Billie has done an outstanding job in facilitating improved communication and oversight that is ensuring patients are receiving high-quality, consistent care from all institutions, physicians and others who may be involved in their care, no matter where they may receive it.  Further, Billie has established multiple regional partnerships with area agencies and not-for-profit organizations that are focused on health related issues,” Kinyon said.

Kester said the nurses involved in her father’s healthcare experience made a lasting and inspiring impression. When she had opportunities to move into nurse leadership roles, she said she saw that as “an even greater opportunity to make a difference in the lives of patients and families.”

With health care’s historic shift from episodic care to broader efforts to improve community health, prevent or better manage chronic illness, she was even more certain. “As health care progresses into population health management, it further embodies the very reason I want to be a part of it,” she said.

Perhaps her love of math, which involves finding solutions to problems, helped her take on what for some would be a daunting challenge. How do you improve patient care being delivered by numerous institutions and caregivers, often not directly connected or even sharing information about the care? What could Reid Health do to help ensure patients remain healthy when they are at home or in the care of someone else? What could be done to better equip patients to understand and follow through with their instructions for care and medications after they left the hospital?

“The transition puts more of the control back into the hands of the patient, allowing them to be the true drivers of their care.”

These questions led to the establishment of teams like Reid Health’s Transition Coaches, which provides a nurse to help the patient after they leave, should they need it. Setting up collaborative groups such as the Community Care Connections, a regional nursing home collaborative focused on quality improvement has improved communication among healthcare providers and helped everyone do a better job of overseeing the care of patients, said Kester, who helped launch the partnership.

Kester realizes that people may not always understand what terms like “population health management” or “care across the continuum” mean. She said what the terms mean for patients is easier to understand – they are seeing better communication and coordination in how everyone is providing their care. “The focus in the past was on volume – volume of patients, visits, procedures. Now the focus is more on the value and quality of care everyone provides and ensuring that services are provided at the appropriate time and in the appropriate setting.”

These efforts have already proven successful in helping avoid the complications that can cause a patient to have to return to the hospital after they were released. Patients and their families are learning more about their needs and getting more help with managing their health. “There is a greater focus on ensuring that the patient is able to appropriately manage their condition rather than have health care professionals manage it for them,” Kester said. “The transition puts more of the control back into the hands of the patient, allowing them to be the true drivers of their care.”

Part 1: The Journey to Population Health Management

Part 2:  For new Reid Health nurse leader, it’s all about connections