Hospital's swing bed offers time, place to truly recover

By CHARLIE SMITH,

Dr. Charles Griffith refers to the swing bed unit at Marion General Hospital as the “Dollar General of health care.”

“Because we think you should get quality care for lower prices,” he said.

Patients recovering from a hospital stay who are still too sick to go home can spend one to three weeks recovering, while having all the resources of the hospital to help them achieve that goal.

Griffith says the system provides “extraordinary” value and that the Columbia community benefits by having a high level of care in patients’ home town. The patients, often depressed about facing serious illnesses and long hospital stays, have more access to friends and family to keep their spirits up.

“It’s a lot easier for their 60-, 70-, 80-year-old friends to drive around the corner or come by after church when it’s in town than go all the way down 98,” Griffith said.

He can also give day passes to go outside the hospital for a few hours for things like church or lunch with a friend.

“I had a gentleman take someone on a date once. The lady drove,” Griffith said, adding that was a rare exception.

He said the hospital is also critical to the economic life of the community with the money and employment helping the community survive.

“The population supports the hospital, but the hospital supports the community,” he said.

Griffith said he’s always been drawn to such rural practices and traditional medicine. He grew up in Shreveport, La., the son of a physician, and loves the practice of medicine and its traditions. He graduated from medical school at LSU and did his residency at the University of Florida as a “traditionalist” who treats all types of patients. He has been practicing in the Pine Belt since 2002 at several locations and said the swing bed is still a piece of traditional medicine that affords him the time to sit and talk with patients.

He said he’s always had a heart for the elderly, delighting in their stories, spirit and humor, and also loves the people drawn to this style of practice and the team-based approach.

“When you’re on swing bed you’re not a doctor in your clinic with a patient,” he said. “You’re a doctor in the hospital with your patient and the dietician and the therapist and the pharmacist and the nurses and the aides. Everyone has a part to play.”

Patients who come to the swing bed unit often arrive after being hit without a warning by a serious problem: hip fracture, stroke, pneumonia.

“Suddenly this person, and the people that love them, are thrown into a completely new reality. ‘Wait a second; what do we do now? Dad always took care of mom, and now he is going to be bed bound for weeks,’” Griffith said.

The plan is to help such patients “transition” from one level of care to another.

Such transitional care is emerging as a specialty and includes post-acute units like swing beds, long-term care like nursing homes, home health and hospice.

Swing bed means a bed in the eyes of Medicare can “swing” between an acute stay and a post-acute stay.

“You could be admitted to one of these rooms, and you complete your acute care stay for whatever illness, but you’re too weak to go home. You need an intensity of care that can only be delivered in this setting,” he said. “Home health is not quite enough for hundreds of reasons: Delivery of complicated medications, the need for closer monitoring 24/7 by skilled nurses and access to a physician who can give, at anytime, orders: ‘Give me this X-ray; give me this IV; let’s do this wound vac.’”

The goal is to reach the highest level of independence that you can achieve. Ideally, that means a patient goes home, but they might end up at a senior living facility or nursing home.

Griffith comes to Marion General on Wednesdays but is on call 24/7. He’s done it for five or six years now and says he knows the patients and nurses, which allows for continuity of care.

Griffith said he needs to instill in patients a fire to want to go home after they’ve been in a hospital bed for several weeks and are diminished in spirit.

“You start to think unhealthy thoughts: ‘I’ve been in this room and in this bed for five weeks. This may be it.’ And I have to be like, ‘It’s not it; let me tell you why,’” Griffith said.

Rural hospitals like Marion General take pure Medicare, not a Medicare replacement plan.

“Medicare replacement plans, Humana, Health Spring, they just don’t cover it properly,” Griffith said.

Most of the time the swing-bed unit gets calls from hospitals about patients and some come from home. It generally requires three midnights in a hospital within the past 30 days and a qualifying diagnosis.

That is, the patient must have a serious enough problem to require that amount of care.

Patients are evaluated on a weekly basis with the two-pronged goal of medical stability and functional improvement, Griffith said, so that there’s assurance the patient will continue to improve when they get home.

“How many times do you hear people say, ‘They sent me home too soon. I wasn’t well yet. They just kicked me out.’ Well, there was a time when people could stay in the hospital longer. I was during that time. You might stay one or two days later ... just to be sure we’re OK. That’s impossible to do now,” Griffith said. “The cost for those hospitals is way too high, and the need for those beds is way too great.”

And the flip side of that coin is Griffith said studies show that if you stay too long in an acute hospital you’re at risk for problems like infections despite high standards of safety. Yet you’re clearly not well enough to go home.

“So where else in health care do you have time to truly let folks recover? Let the wound knit. Let the pneumonia resolve. Let the kidney recover. Let the appetite return. Let the muscles strengthen. Let the balance be restored,” Griffith said. “Where else? Nowhere.” 

Pictured Above: Registered Nurse C.J. Smith, left, and Dr. Charles Griffith talk in the swing bed unit at Marion General Hospital. Griffith says the system provides “extraordinary” value and that the Columbia community benefits by having a high level of care in patients’ home town, where they are more connected to support from family and friends as they recover. | Photo by Charlie Smith

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