Introduction – Seamless communication across the continuum of care

HMT editor’s note: We will trace the principles described below in action as we follow Vocera Communications’ projects and, over the next several months, we will post online the first of several features describing how Vocera technologies and services improve both patient experiences and their care outcomes.

A breakdown in communication in a health system, hospital or clinic can have a significant impact on clinical outcomes, patient and staff experience – and the organization’s performance. According to the Joint Commission, 62 percent of accidental deaths and 80 percent of serious medical errors are linked to communication failures. In addition, research from the University of Maryland revealed that communication inefficiencies result in $12 billion in excess costs or lost revenue annually. Therefore, it is essential that organizations transform communication and care coordination to reduce avoidable readmissions and elevate patient satisfaction. Successful organizations create a consistent, seamless experience of care from pre-admission to discharge, connecting with primary care physicians, skilled nursing facilities and other healthcare care providers.

To improve the healthcare experience, Vocera Communications has worked with frontline staff and hospital executives to create Vocera Care Experience, a single platform that unifies care team, patient and family communication across the entire continuum of care. The Pre-arrival module within the solution allows hospitals to provide logistical and clinical guidance for patients prior to arrival to help ease the admission process, set expectations and create an ideal first impression. During a hospital stay, the Care Rounds application is used to standardize the practice of leader rounding and provide meaningful and actionable data. Nurse leaders use the application on a handheld device to capture patient and family requests, questions and compliments. With this feedback, care teams can proactively address potential concerns, track resolutions and recognize exceptional staff members.  

By combining the practice of nurse leader rounding with post-hospitalization follow-up calls, organizations can improve patient perceptions more so than using one of these tactics alone. During a single hospital stay, one patient may have experiences with multiple departments ranging from the front desk, radiology, nutritional services, case management, pharmacy and more. If each department conducts follow-up calls, this lack of coordination is likely to create frustration for the patient and fuel inefficiencies in hospital workflows. The Care Calls solution by Vocera manages the patient follow-up call process by triaging patients according to readmission risk, offering tailored scripts, providing patient call history, and documenting patient and family feedback. Follow-up calls made within 48 to 72 hours after hospital discharge are proven to increase patient satisfaction and help reduce readmissions.

The discharge process is often a pivotal point in the patient journey where communication breaks down. Typically, at the end of a hospital stay patients are not feeling well, are anxious or are ready to leave the hospital. During this transition, the patient and family may find it difficult to listen to or comprehend even simple discharge instructions. Studies show that patients who understand their post-hospital care instructions are 30 percent less likely to be readmitted to the hospital or to visit the emergency department. Innovative nurses and physicians are using the Good to Go solution, a HIPAA/HITECH-compliant application on a handheld device, to record discharge instructions at the patient bedside. This mobile app also captures educational care videos, informational images and personalized care plan documents. After hospital discharge, this multimedia information is available 24/7 for patients, families and caregivers to review via any phone, mobile device or computer using secure log-in credentials. In 2014, the Institute for Healthcare Improvement recognized the practice of recording discharge instructions as an Always Event, an aspect of the patient experience that must be performed consistently for every patient, every time. One of many hospitals practicing Always Event procedures reduced its readmission rates by 15 percent and improved Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores by 63 percent in the domain of discharge communication.

Hospitals that can reduce readmission rates while simultaneously improving patient experience will reap the benefits of maximized reimbursements, lower costs and higher market share – and patients will enjoy a better experience and higher quality care.

References

1. Joint Commission. www.jointcommission.org.
2. Agarwal R., Sands D.Z., Schneider J.D. Quantifying the Economic Impact of Communication Inefficiencies in U.S. Hospitals. Journal of Healthcare Management. 2010; 55(4):265-281.
3. Nina Setia, MS, Christine Meade, Ph.D. Bundling the Value of Discharge Telephone Calls and Leader Rounding. The Journal of Nursing Administration. 2009; 39(3):138-141.
4. Project RED,^® a registered trademark of Brian W. Jack, M.D., and the Boston University/Boston Medical Center
5. Project BOOST,^® a registered trademark of the Society of Hospital Medicine.
6. Brian W.Jack, M.D., et al. A Reengineered Hospital Discharge Program to Decrease Re-hospitalization.  Annals of Internal Medicine. 2009;150:178-187.
7. Institute for Healthcare Improvement. www.ihi.org