An Initiative to Improve Patient Discharge Satisfaction

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Transcription:

An Initiative to Improve Patient Discharge Satisfaction

Speaker Disclosure Statement Sally Strong, RN, APN-CNS, CNRN, CRRN Clinical Nurse Specialist Marianjoy Rehabilitation Hospital Adjunct Faculty Elmhurst College College of DuPage The planner and presenter of this session have no financial relationships or conflicts of interest to disclose.

Challenges to successful discharge Lack of familiarity with rehabilitation Decreased length of stay Increased patient acuity Patient/caregiver perception that they are not adequately prepared for discharge

Journey to Discharge Concept Better informed patients and families will lead to better satisfaction scores

Journey to Discharge Concept Development Implementation Evaluation Revision

Development Press Ganey scores reflected patient dissatisfaction with discharge process The need to clearly communicate how a patient progresses toward discharge was recognized

Development A multi-disciplinary team initiated a tool to be used for patient education Focused on using patient centered communication

Understanding Rehabilitation Areas of confusion for patients/caregivers regarding the rehabilitation process at Marianjoy: Differences between acute care and rehab Concept of multi-disciplinary care Understanding of patient goals and their relationship to discharge plans

Design of Journey to Discharge Tool To identify areas of concern the team walked through the entire patient experience The decision was made to use a roadmap concept as that is familiar to many people

Design of Journey to Discharge Tool The tool was named Your Inpatient Journey Along the Rehabilitation Road to Discharge Each segment of the road map describes the patient experience

Journey to Discharge Tool Planning the trip pre-admission Evaluation by physician/liaison Acceptance at specific level of care

Journey to Discharge Tool Starting the journey - admission Welcome to facility Receive Patient Handbook Receive personalized Patient Education Notebook

Journey to Discharge Tool As you travel - your stay at Marianjoy Evaluation by rehabilitation team Setting of goals in conjunction with patient Ongoing education by rehabilitation team

Journey to Discharge Tool As you travel - your stay at Marianjoy Daily physician visits Weekly interdisciplinary conference Patient/caregiver progress updates

Journey to Discharge Tool As your trip concludes - transition to discharge Ongoing education by rehabilitation team Family education visit Therapeutic pass

Journey to Discharge Tool As your trip concludes - transition to discharge Identification of post-discharge destination Home with outpatient services Home with Home Health services Sub-acute

Journey to Discharge Tool Reflecting on the journey during/after discharge Provision of resources Phone numbers Support groups Levels of care for ongoing needs Outpatient therapy Sub-acute Physician clinic

Journey to Discharge Tool Reflecting on the journey during/after discharge Follow up phone call Press Ganey survey

Evolution of Follow-Up Calls Tracked Press Ganey feedback for trends Identified post-discharge issues Provided support for 0.5 FTE RN Implemented calls 24-72 hours post discharge as part of Journey to Discharge initiative

10 Questions Any difficulties in your living environment? Do you have the equipment you need? Any questions about your medications? Did you feel prepared for discharge? Have you made your doctor and therapy appointments?

10 Questions How was your care? Anything we could have done differently? Would you like someone to call you back regarding these concerns? Anyone you would like to compliment? If you receive a survey, will you complete it and return it?

Patient/Family Response to Calls All is well Appreciation Help! Concerns Compliments

Use of Follow-Up Call Results E-Mail leaders for real time issue resolution Share data with executive team monthly Track trends Record readmission rates Survey return rate Patient satisfaction scores

Process Improvement Initiatives Discharge medication management Patient education Nurse and physician collaboration in process Development of weekend walking program

Process Improvement Initiatives Collaboration with food services Patient access to technology Multidisciplinary discharge checklist in development

Implementation of Journey to Discharge Tool Multi-disciplinary effort Team solicited feedback from staff and patients on original document Tool was piloted on one unit

Implementation of Journey to Discharge Tool Clinicians were provided with talking points and FAQs to assist in communication with patients Implemented throughout hospital within 3 months

Evaluation of Journey to Discharge Tool Positive patient feedback regarding ease of understanding Staff were slow to incorporate Journey into patient education Increase in Press Ganey scores regarding discharge

Revision of Journey to Discharge Tool Patients requested an area to write their goals Rewording of some segments to have more descriptive language

Revision of Journey to Discharge Tool Possible destinations were highlighted more clearly Incorporated a previous document with staff names and phone numbers into Journey Tool Copyrighted

Thank you!

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