Читать книгу You Make the Call - Healthcare's Mandate for Post-discharge Follow Up - Kristin Boone's Baird - Страница 5

Making follow-up calls to patients has always made sense to me as part of a logical progression of patient care and as a method for closing the information loop. During my years as a nurse working at the bedside, I would take care of patients while in the hospital yet wonder how they were faring once discharged to their homes. Were they doing alright? Did they understand their instructions? Did they have the help they needed? Even though I was confident in the care patients had received and the information offered upon discharge, I often had this nagging feeling inside, wondering if we should get validation that patients and their caregivers felt confident and fully prepared to manage needs at home. I strongly wished to just check in with discharged patients and see how things were going, but demands for my time at the bedside precluded me from making the calls I felt sure would make a world of difference to my patients. This compulsion for a systematic feedback loop to my patients followed me into my work as the manager of a nurse call center.

In 1989, I was managing a nurse call center that handled 120,000 calls per year. My team of registered nurses was armed with protocols for triaging caller concerns about everything from infant teething to chest pain. The typical inbound calls were initiated by a customer with specific needs—usually symptom-based concerns—but other calls concerned physician referrals and registrations. It was not uncommon to have patients contact our call center with questions about their recent discharge instructions, medications, or follow-up appointments. It dawned on me that we had the perfect set up to manage not only the inbound requests for information, but to make outbound calls to our recent discharges as well. Hence, our follow-up service was born. Within weeks, we were up and running making follow-up calls to patients discharged from the hospital’s inpatient units as well as those treated and released from the emergency department. Back then, we didn’t have the sophisticated computer technology that exists today, but we were driven by the same goals many of us have today:

•Validating patients’ comprehension of and adherence to discharge instructions

•Assisting in answering questions and securing follow-up appointments to maintain compliance

•Maintaining a warm connection between patients and the organization

What made sense then still does and will continue to make sense in the future. Patients come in contact with hospitals and other healthcare organizations when they are feeling vulnerable, frightened, and confused. They are often hurting physically and emotionally. And, despite our best efforts at education and thorough discharge instructions, their time with us is not the optimal “teachable moment.” They often leave the hospital or clinic only to find themselves wondering about next steps. Now that the Centers for Medicare & Medicaid Services (CMS) are placing greater accountability on hospitals to prevent unnecessary readmissions, hospitals are scrambling to do whatever they can to ensure patients leaving the hospital maintain a connection to medical professionals and timely advice. Value-based purchasing has created a burning platform for hospitals to decrease readmissions and improve patient satisfaction.

Improving the patient experience has always been a central theme in my career, whether it was at the bedside, in leadership positions, or in my consulting role. I’ve always felt that, regardless of the nature of the healthcare encounter, consumers should leave every encounter feeling more knowledgeable about their conditions and more comfortable in taking the necessary next steps than they did before. If we as an industry are going to create a truly patient-centered experience, we must embrace follow-up efforts as an integral part of the total experience. But success will not happen by chance—it must be created by design.

The following chapters will provide rationale as well as tools and examples of successful approaches you can take in weaving follow-up calls into your care and patient experience game plan. When it comes to follow-up calls, it’s no longer just a nice thing to do for your patients—it’s necessary. So let’s get started now.