CipherHealth CNO Says It’s All About Making Patient Follow-up Easier and More Efficient
As a young nurse thirty years ago, I remember being trained on ways to effectively discharge a patient. Although patient education was our highest priority, we were trained to remember that “the patient is your responsibility until you escort them from the hospital in a wheelchair (always) and get them safely into their car or other mode of transportation.”
Since my training days, healthcare has undergone dramatic changes. When I started my nursing career, if patients experienced issues after leaving the hospital, they could always come back. We would care for them and yes, we would get paid for that service. Chronic patients were almost expected to revisit the hospital and were often thought of, affectionately, as “frequent flyers.”
Is patient follow up emphasized enough?
As payment reform has taken shape, hospitals are responsible for patient outcomes even after a patient is wheeled to their car. Although there is greater incentive to care for and educate the patient after discharge, patients still rely on printed packets of discharge instructions. These are often difficult to comprehend and can result in critical health information being missed if the patient is confused, frustrated, or opts out of reading further.
For this reason, having clinicians reach out to patients after discharge can make a profound impact. This critical connection can mean the difference between satisfied and unsatisfied patients - narrowing the gap between patients at risk for readmission and those on the path toward recovery. The question remains, why then, do so many healthcare organizations fail to connect with patients after they are discharged from the care setting - knowing the profound impact that even a simple phone call can have?
Patient outreach should be more than just another item on a to-do list
Throughout my years as a nurse, the professional practice of nursing has evolved tremendously. What has remained consistent is that nurses must constantly prioritize and re-prioritize care delivery tasks; and with a never-ending to-do list, nurses are feeling burnt-out at higher rates than ever before. Adding manual phone calls for discharged patients to the nurse workflow is difficult. Navigating incorrect phone numbers, calling patients back if they didn’t answer, and not being able to quickly retrieve pertinent information are just some of the many challenges faced when trying to drive results. It is no surprise that a recent Modern Healthcare survey highlighted that only 16% of healthcare leaders are happy with their current outreach programs and 57% of respondents indicated that labor cost was prohibiting them from implementing more effective follow up programs.
These statistics and my personal experiences make me wonder why organizations are so averse to automating the initial patient outreach process. Automation allows precious nursing resources to be allocated to those patients who are in need of follow-up care. Instead of nurses calling every patient, an automated system allows those calls to be “triaged”; providing the nurse with a list of patients who have outstanding concerns.
Although there are plenty of examples of “robo-calls” gone wrong, automated outreach and engagement technology can be more personalized than leaders may realize. To add personalization to automation, healthcare organizations can leverage EMR integration to deploy DRG-specific questions, provide a local caller ID to increase the likelihood that patients will answer the phone, record the voice of your CNO in the outreach message to provide a human touch, and above all, leverage the right communication modality to reach the patient population (such as calls or SMS text messages). By tailoring proactive outreach efforts to the specific needs of the patient population and triaging those individuals needing additional support, healthcare organizations can reach more patients - as well as empower nurses to focus their time and expertise on intervention.
The Proof is in the Pudding
Automated outreach as a patient engagement strategy is proven to improve outcomes. For example, patients triaged with automated technology at Sentara Healthcare were 3.4 times less likely to be readmitted compared to those who received manual follow up. Although this statistic is impressive, every data point represents a patient life. As a nurse, I know all too well that there are many variables impacting patient outcomes that lie beyond our control. This component of the patient experience is wholly within our control, so results are especially compelling.
I recently heard the story of a Spanish-speaking mom whose son had recently received nasal packing after sinus surgery. Once home, she was unsure of the correct protocol for gauze removal. After receiving an automated call in her primary language, she was able to indicate that she had additional questions regarding her son’s discharge instructions. The nurse from her hospital was immediately notified, quickly connected with the mom to discuss the proper protocol for nasal packing and scheduled a follow-up appointment for her son. This happy ending contrasts sharply with what could have been if she had not received a timely call. The mom may have tried to remove the gauze herself leading to additional (and unnecessary) frustration, pain, or worse, injury to her son.
Focus on the Continuum of Care
The clinical implications of this type of outreach are profound and include the reduction of 30-day readmission rates, as well as improved patient recovery and quality of life after discharge. This meaningful interaction speaks volumes to patients and family members.
Healthcare organizations can leverage this proactive outreach to enhance communication with patients, ensuring that they had a positive experience. This may also serve as an opportunity to conduct any service recovery efforts that may be necessary. With 92% of healthcare leaders indicating that CAHPS are a key performance indicator, the impact of post-discharge interactions can be felt at both the individual patient and organizational level.
Despite what I was taught 30 years ago as a new nurse, assisting a patient via wheelchair to the car is by no means the last chapter of the patient journey - it is the next step in the care continuum. In this era of value-based care, patient follow-up and outreach are essential.
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As CipherHealth’s CNO, Lisa Romano, RN, MSN is passionate about improving the health of patients across the healthcare continuum. Romano brings more than 25 years of clinical practice, healthcare IT strategy, and healthcare operations experience to her current role. Prior to previous CNO roles, Romano spent 19 years as a nurse and hospital administrator at Lehigh Valley Hospital and Health Network in Allentown, PA, where she was responsible for all patient flow and transfer center operations as well as numerous quality and patient satisfaction initiatives.