The Michigan Value Collaborative

Helping Michigan hospitals achieve their best possible patient outcomes at the lowest reasonable cost

Month: June 2017 (page 1 of 2)

Reducing Readmissions through Quality Discharge Planning

Deby Evans

Deby Evans is the Site Engagement Manager for the MVC Coordinating Center.

According to various literature, the quality of discharge planning can affect the likelihood of readmission. As hospitals search for ways to reduce their readmission rates one of the components to review might be the quality of discharge planning. A recently published study found that not only did higher quality discharge planning result in reduced readmission rates, but it also helped hospital retention rates for those patients that did need readmission. Retention of patients is important not only to maintain continuity of care but also for financial reasons. To read more on the study click here: http://journals.sagepub.com/doi/pdf/10.1177/1077558716647652

So what does quality discharge planning entail? Another recent study showed that quality discharge planning not only effectively informs patients about their discharge plan, but includes ways in which patients will carry out the plan and have the ability and willingness to execute it. In order for patients to become more actively involved in their discharge plans, hospitals should work in conjunction with their outpatient clinics and utilize many of the available community resources they may have. To read more on this study click here: http://qualitysafety.bmj.com/content/26/1/7.full

Two facilities that have incorporated liaising with outside agencies for quality discharge planning and to ultimately reduce readmissions are: The University of Virginia Health System and Christian Hospital in St Louis.

The University of Virginia (UVA) Health System has developed their Hospital to Home program to focus on the two-week time period after discharge. On the morning of discharge, the members of the entire patient care team meet with the patient thus incorporating all aspects of the patient’s care in to the discharge plan. To also help reduce confusion over the discharge plan, UVA Health System provides the patient with an easily understood discharge summary; one that contains no uncertainty or dubious information. This discharge summary is reviewed not only with the patient but with a family member as well. For heart failure patients, a one-hour long appointment at an in-hospital clinic is scheduled between four and seven days after discharge. During this appointment, a nurse practitioner reviews medication and diet. For more on UVA click here: http://www.hhnmag.com/articles/8327-case-study-post-discharge-planning-cuts-readmissions-at-uva

On another note, Christian Hospital in St Louis worked with 911 dispatchers and paramedics to reduce the utilization of their emergency department through the Community Health Access Program (CHAP). To help provide patients with the appropriate support they need, Christian Hospital set up access centers with coordinators who develop relationships with patients and are able to help procure resources. The development of CHAP has helped reduce overcrowding in the emergency department, reduce utilization of ambulances and paramedics and improve the quality of life for many in the community. For more on the CHAP program click here: https://www.christianhospital.org/Community/CHAP

Interested in learning more about Hospital to Home programs? Click here: https://cvquality.acc.org/initiatives/hospital-to-home

 

 

Patient Navigators and Their Value to Hospital Care

Abeer Yassine

Abeer is the MVC Hospital Engagement Associate

Since the 1990s, patient navigators have helped guide and support patients through a diagnosis, or suspected diagnosis, to address any barriers patients may encounter within the health care system. This ensures patients are informed and receiving timely treatment. Patient navigation programs have traditionally been attributed to oncology; however, these programs have demonstrated value across different lines of care, especially in geriatric care where care is costly and multifaceted. 1

Patients can benefit immensely from navigator programs. Navigators ultimately ensure that patient needs and questions are addressed, that they are adhering to their medication plans, and that they are well-informed of their diagnosis and treatment status. By working one-on-one with patients, navigators help address broader health disparities, such as language barriers, that may not be feasible to clinicians due to resource and/or time constraints. This helps support patients during critical, and often complex, times in their health by providing them with the necessary tools and guidance needed in treatment and healing. 2

Patient navigator programs benefit not only patients, but also help improve cost outcomes. A study by Rocque, Gabrielle B., Pisu, M. et al. examines cost and resource use related to cancer among older adults (Medicare beneficiaries 65 years or older) receiving care at The University of Alabama at Birmingham (UAB) Health System Cancer Community Network (CCN). In the study, the Patient Care Connect Program (PCCP) was implemented, which aimed to optimize costs through the integration of lay navigators within the CCN. Using claims data, navigated patients and non-navigated patients were observed from 2012-2015 for any changes in total Medicare costs and resource use.  Costs related to hospitals, outpatient, and physician visits were examined. Those in the navigated group, comprised of a single navigator and 152 patients, had declining costs for a total of over $475,000 reduction, annually. The reduction takes into account an average salary and benefit investment estimated at $48,448 for the navigator. ED visits and hospitalizations of those in the navigated groups decreased by 6% and 10.6%, respectively, per quarter compared to those in the comparison group (non-navigated). The study helps quantify the value of patient navigators in a health care setting, including through the prevention of ED and hospitalizations that may also improve patient experience. This study can be found here: http://jamanetwork.com/journals/jamaoncology/fullarticle/2598743 1

Incorporating a patient navigation program into a health system can be beneficial to different parties involved in patient care. The benefit gained from patient navigation programs supports value-based care models that are being implemented across the nation. These programs ensure that patient needs impacting clinical outcomes are being addressed and support hospital financial viability. Although patient navigation is not brand new, programs are now surfacing as they support the goals of the movement towards value-based care.

 

 

1Rocque GB, Pisu M, Jackson BE, Kvale EA, Demark-Wahnefried W, Martin MY, Meneses K, Li Y, Taylor RA, Acemgil A, Williams CP, Lisovicz N, Fouad M, Kenzik KM, Partridge EE, for the Patient Care Connect Group. Resource Use and Medicare Costs During Lay Navigation for Geriatric Patients With Cancer. JAMA Oncol. 2017;3(6):817-825. doi:10.1001/jamaoncol.2016.6307

2 Paskett ED, Krok-Schoen JL, Gray DM. Patient Navigation—An Effective Strategy to Reduce Health Care Costs and Improve Health Outcomes. JAMA Oncol. 2017;3(6):825-826. doi:10.1001/jamaoncol.2016.6107

Older posts