OPTIMISTIC health care study aims at saving lives, money

Betty Grady administers care to 80-year-old Ola Bluitt.

Indiana University is undergoing a sizeable effort to improve the quality of care for seniors who live in nursing homes and cut health care costs at the same time.

IU has placed an extra resource, registered nurse Betty Grady at Rosewalk on the east side of Indianapolis.

"I think this is what I was born to be, an optimistic research nurse. I love this. I feel like I can make a difference," Grady said.

She is one of 25 RNs or nurse practitioners with an extra set of eyes on 2,000 patients at 19 central Indiana nursing homes who helped identify an early infection in resident Ola Bluitt.

"I didn't know that I had pneumonia. I knew that I wasn't feeling well and I just couldn't understand what was going on with my body," the 80-year-old resident said.

With new "OPTIMISTIC" protocols, subtle changes in Ola's health were flagged and documented on a new "Stop and Watch" form, which led to more care.

"Because we started the antibiotic early, we were able to catch the pneumonia early and she was able to stay here at home," Grady said.

That's a better option than going to the hospital, where seniors like Ola are more vulnerable to infection and confusion.

"They have long waits when they go through the emergency room. They don't know anyone there, so there is also that fear factor," said Grady.

It's part of a Centers of Medicare and Medicaid Service, a seven-center effort, including IU.

"It's one of those situations in healthcare where we can improve care and reduce costs. It does go hand in hand," said Dr. Kathleen Unroe, co-director of OPTIMISTIC.

It's about care and in conflict with financial incentives in place now, which favor hospitalizations of patients like Ola. If she seems to be getting sick, her doctors can be paid more if she is seen in the hospital and facilities like Rosewalk receive more than double the reimbursement money for the days they care for Ola after she is discharged from the hospital.

"Policymakers in D.C. see that as major reasons that these avoidable transfers occur," Unroe said.

Unroe predicts the results of the four-year study will impact where federal resources for nursing home residents are distributed long term.

"I do see a lot of successes. Ola is just one of the successes," Grady said.

"It gives me peace of mind, because you want to know that your mother is taken care of and I don't worry when I have to go to work and I'm not around her. I know that she is in good hands," said Ola's daughter, Camille Fields.

OPTIMISTIC is an acronym for Optimizing Patient Transfers Impacting Medical Quality and Improving Symptoms Transforming Institutional Care. It's a mouthful, but the impact could be measure in saved lives and billions of dollars.