Coordination is Key to Reducing Pancreatitis Patient Hospitalizations

By IU Health Senior Journalist T.J. Banes, tfender1@iuhealth.org

On any given day, Kathy McGreevy can have 15-20 phone conversations with patients. Some last a few minutes; some last longer. Some are initiated by McGreevy, others are incoming.

For more than a decade, IU Health Dr. Nicholas Zyromski, who specializes in hepato-pancreato-biliary surgery, had a vision. That vision was to have a nurse navigator serve as a liaison between physicians and patients - specifically, patients who suffer acute pancreatitis. Dr. Zyromski’s vision has been both realized, and fully supported by IU Health President and CEO, Dennis Murphy, the Surgical Outpatient Clinic (SOPA), and SOPA Clinic manager, Maureen Colin.

McGreevy – who has been a nurse for 32 years - stepped into that role three years ago. Prior to joining IU Health, she was a research nurse in Gastroenterology with the IU School of Medicine for 16 years.

The role as nurse coordinator with the Necrotizing Pancreatitis Program at IU Health was a perfect fit. McGreevy pairs broad-based knowledge with clinical resources to make personal connections with patients.

“I’ve met most of the patients when they are admitted to the hospital with acute pancreatitis,” said McGreevy. Those patients range in age from their 20s to their 70s and their symptoms can be caused by several factors to include gallstone obstruction, medication-induced or alcohol-induced acute pancreatitis.

The most severe conditions can advance to necrotizing pancreatitis.

“Necrotizing pancreatitis is an inflammatory condition that can lead to organ failure, respiratory failure, and deep vein thrombosis (blood clots). To help prevent pulmonary embolism, we have implemented weekly ultrasound studies of the patient’s arms and legs, to screen them for deep vein thrombosis (blood clots),” said McGreevy. “The danger is if the blood clots migrate, they can travel to the lung and cause pulmonary embolism, so you want to start the patients on an adequate dose of blood thinners right away,” she added.

Treatment continues after patients are discharged. In between their clinic visits and sometimes during rehabilitation, McGreevy is their “go-to” person to help reduce hospital readmittance.

“I become like a family member,” said McGreevy. “It’s extremely rewarding and very challenging. These are very sick patients, and to see what they go through, and to help them navigate through it is amazing.”

On average, 72% of patients diagnosed with acute pancreatitis are among the highest of any medical disease to experience unplanned readmission. The Necrotizing Pancreatitis Program at IU Health was created to improve patient outcomes. Ongoing communication helps identify developing problems faster and decrease unplanned hospital readmissions.

On average about 64% of patients are readmitted due to complications such as organ failure, critical care requirement, infection, malnutrition, and physical deconditioning.

From 2016 – 2019, a team of IU Health surgeons conducted a study and researched ways to improve t patient outcomes. That’s where McGreevy came in. She follows up with patients three to seven days after discharge and then again seven to 14 days. She continues to follow up with patients for six months up to a year. The calls are focused on patient concerns and monitoring for any complications.

Since the beginning of McGreevy’s role with the Necrotizing Pancreatitis Program, the patient readmission rate has decreased from 64% to 45%.