The case for implementing a post discharge call program

In November 2015, the Center for Medicare and Medicaid Services (CMS) announced a new proposed ruling that hospitals establish a post-discharge follow-up program.

The ruling is based on a number of recent findings from CMS and the AHRQ that focused on transitioning patients from the hospital to their home or home health agency. The study by Anna Sommers and Peter J. Cunningham for the National Institute for Health Care Reform1, stated that "1 in 12 adults discharged from a hospital is readmitted within 30 days, added $16 billion to the cost of healthcare in the United States, and, according to analysts, it underscores the need for a comprehensive approach to reforms."1

California also recently enacted a new state law, backed by the American Association of Retired Persons, that state hospitals identify a caregiver during the patient's hospitalization and also inform them of the patient's discharge date and instructions and medication regime. Some patients' caregivers complain that they aren't often kept in the loop regarding important details of the patient's status and that the discharge process is confusing and complex.

The AHRQ has also reported in one of their recent studies that one in five patients has a complication or adverse event after being discharged from the hospitals, and yet another study from all Florida hospitals found that 7.86 percent of hospital admissions were potentially preventable, related to the original condition requiring admission, and occurred within the first several weeks after discharge.2 Each of these findings point to the conclusion that hospitals would benefit greatly by implementing a post-discharge call program at their organization.

Along with cost, other supporting evidence for a post-discharge follow up process include patient compliance, adherence to discharge instructions and medication regimens, all which point to an improved care transition. The official proposed ruling can be viewed at http://federalregister.gov/a/2015-27840.

In-House vs. Outsourcing Your Program

Once the decision has been made to implement a post-discharge program, the next step is to determine who will oversee and provide this function for the hospitals. While it may be perceived as a more efficient cost alternative, implementing a post-discharge program in-house can have several unforeseen drawbacks.

As with any new program, several factors will have to be addressed, mainly "What additional resources will be required to implement a post-discharge program?". These may include additional operational cost, additional information system requirements, not to mention adding staff to oversee the program. This along with other additional unforeseen cost may lend itself to outsourcing your program to a third-party vendor.

Outsourcing your program has a number of benefits, mainly the confidence that you are working with a vendor with well-defined and built in quality standards, not to mention the assurance that the program has established and standardized processes for implementation at your facility. Your staff can also focus more on patient care and not stuck in a room making phone calls all day.

Along with this, there are financial advantages to outsourcing your program as well. First, these type of programs typically have a very low implementation cost and can show immediate return on investments. The Healthcare Utilization Project (2009) estimated just one unplanned readmission could cost a hospital eight thousand up to thirteen thousand dollars depending on the patient's diagnosis. Once implemented, the prevention of just one or two potential unplanned readmissions could essentially pay for the entire program.

Additional functions and benefits of a post-discharge follow up call program include;

  • Determines patient compliance with discharge instructions
  • Notifies hospitals immediately for any areas of concern
  • Evaluates patients for medication compliance
  • Captures the patient's overall satisfaction of the hospital
  • Captures patient comments for additional follow up

Regardless of how an organization chooses to implement the program at their facility, the case for a post-discharge follow up call program is clear. Each of the factors mentioned provide strong evidence that a well thought out post-discharge follow up program will lead to improved quality of care, reduced hospital readmissions, and cost savings for their organization.

Jay Bishop, COO, J. L. Morgan & Associates

http://www.nihcr.org/Reducing_Readmissions
http://www.modernhealthcare.com/article/20151029

About J. L. Morgan & Associates:
For over 15 years, J. L. Morgan has been a trusted leader in providing healthcare research and phone surveys for over two hundred hospitals nationwide. J. L. Morgan is a CMS CAHPS® certified vendor whose goal is to provide their clients, regardless of size, with a statistically sound, cost-effective method of determining, tracking and bench marking all necessary healthcare data. For more information, please visit www.jlmorganandassociates.com.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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