Patient Discharge redesign
Objective
Transform the way patients receive discharge instructions after leaving hospital to decrease readmissions and increase patient satisfaction scores.
Challenge
After documenting the current state and observing the patient’s journey, it was discovered that upon leaving the hospital, patients and their families usually get a print-out of the patient’s health record that a nurse reviews with them providing quick tips on post-discharge care. The way the information is displayed in the record is customized to the needs of doctors and nurses and is full of medical jargon. Patients have a hard time following it and fail to refer to it at home when post-discharge care is critical.
When patients were interviewed about their hospital experience, it was found that patients often do not feel included in the treatment process. In addition, patients often do not want to ask doctors about jargon they do not understand to avoid looking uneducated and end up leaving the hospital confused about their new illness and ways to manage it moving forward.
Idea
University Hospitals excels at clinical care with state-of-the-art procedures by the best health providers. However, the hospital needed to focus on rendering quality human interactions after patients were treated and needed to go home. It was clear that in order for the hospital to decrease the readmissions, they had to move to a patient-centered model and redesign the discharge process to have empathetic and clear communication. Rather than giving patients and their families a print-out of their health records, a new material and process needed to be created to serve the true needs of patients and effectively support their recovery process. This challenge was tackled with the help of nurses, patients, and administration to deliver the best value to patients and bring positive transformation to the hospital system.
Execution
A custom-made patient brochure was developed that patients and their families received when leaving the hospital with clear instructions written in simple laymen’s terms. The brochure focused on each patient individually and captured all the information essential for the successful recovery grouped into three key categories: to know, to do, to fear.
In addition, the brochure follows a matrix structure, detailing each of the categories over time:
At a glance summary - presents key information about why the patient ended up in the hospital, diagnosis and prognosis, care team, and details of the hospital stay.
First 24 hours - provides critical information needed right after the discharge such as which medicines to take and when, wound care, lists follow-up appointments, as well as outlines warning signs and contacts who can help right away.
First doctor follow-up - sets the expectations for scheduling the first appointment, labs and physical therapy that may be prescribed, key topics to discuss and items to bring when seeing the doctor.
Moving beyond - details lifestyle, diet, and exercise adjustments, provides information about support groups and medical studies the patient could participate in.
The introduction of the new initiative had a strong positive impact on the hospital and brought positive transformation, cutting readmission rates by 18 percent and improving patient satisfaction scores by 23 percent. Not only were the patients happier, the hospital also noted improved rates of communication with patients’ support network as the transition to home care went more smoothly, safely and efficiently.
