Integrating CPUP Physicians into Long-Term Acute Care

The shift has provided enhancements to patient care, including a three physician-lead team with staggered start times to accommodate work flow, admissions and discharges to the Specialty Hospital at Rittenhouse.

In addition, the CPUP physicians began to rotate on a two-week cycle rather than one week. In July 2015, Dr. Jerry Jacob, MD, began to work closely with Patient Safety Manager Laura Murphy, BSN, RN, along with the entire clinical team to enhance patient care and work flow.

“One of the most notable impacts of integrating CPUP hospitalists is the benefit to transitions in care. This integration in providers improves communication across the continuum of care and offers comfort to patients in knowing that the same group of physicians will be caring for them from their acute care admission through their discharge from The Specialty Hospital,” says Jacob. “Having worked closely with these physicians, and having been a former hospitalist myself, I can also attest to the excellent quality of their work."

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As part of the Division of Infectious Diseases at Penn Medicine, Dr. Jacob works alongside other infectious diseases physicians with expertise in a wide range of areas to provide consultations at The Specialty Hospital at Rittenhouse, The Hospital of the University of Pennsylvania (HUP), and other entities across the health system.

“This collaboration provides The Specialty Hospital at Rittenhouse Shepherd Penn Partners patients with access to the expertise of some of the brightest minds in the field of infectious diseases,” says Jacob.

Through a collaborative effort led by Dr. Jacob, throughout the year multifaceted responses including additional education, additional decontamination technology and additional intervention implementations to strengthen prevention efforts impacted care provided on our long-term acute care service level.

“As a result of these efforts, our rate of catheter acquired urinary tract infections dropped to zero for the last quarter of the fiscal year, and improved overall from the prior year. Our rate of C. difficile infections has remained exceptionally low after the implementation of the new interventions during the first two months,” says Jacob. “Other efforts include a reformulation of the antibiotic approval process to improve stewardship of antibiotics, preparation for a successful regulatory visit by the Joint Commission, revision of our treatment guidelines for urinary tract infections, education of Penn Medicine Physical Medicine and Rehabilitation (PM&R) physicians-in-training, and a few others.”

Currently, Dr. Jacob is working with staff to formally review all policies related to infection prevention and control, with one of the goals being to find areas were practices can be closer aligned to HUP. Another important project this year was to revamp the process for disinfection of our endoscopes.

In recent years, other facilities across the US have noted transmission of highly drug-resistant bacteria associated with the use of these devices. Infection prevention colleagues at HUP have special expertise in this area, so Dr. Jacob invited them to review practices in person. As a result, revisions in protocol we are able to be made to assure that the highest standards of disinfection are being used to keep patients safe.

“While Good Shepherd Penn Partners is certainly distinct from HUP as a post-acute care facility, there are several areas where creating uniform practices across facilities will create smoother transitions for patients, facilitate better implementation by staff, and strengthen our efforts at preventing healthcare acquired infections,” says Jacob. “We are able to learn from the experiences of other providers within Penn Medicine and work together on infection prevention initiatives across the healthcare system.”

With alignment and infection prevention initiatives continuing to develop through the efforts of the entire clinical team’s collaboration with the health system, both patients and staff with be able to reap the benefits of progress.