A Customized Follow-up Plan to Reduce Hospital Readmissions

A Customized Follow-up Plan to Reduce Hospital Readmissions

When patients get discharged after a hospital visit, it can be difficult for them to follow or remember discharge instructions. This can lead to higher readmission rates, longer recovery times, and overall lower quality of patient satisfaction. Read these tips to see how a customized post discharge follow-up care plan will reduce patient readmissions.

Did you know?
• Up to 20% of patients are readmitted within 30 days[1]
• There is the potential to save $12 billion on readmissions[1]
• Hospitals could lose as much as $528 million from Medicare cuts[2]

Why Hospital Readmissions Occur:

A common cause for readmissions is poor follow-up by patients after the procedure. The stress and difficulty faced by patients during their hospital stay makes it common for them to forget or misunderstand the instructions given by the providers during the hospital discharge. Often times, patients go home confused about their medication orders, fail to follow the treatment plan or neglect to follow-up with a doctor visit in a reasonable time frame.

Family members may be able to help patients follow discharge instructions, but they are often distracted because of the hospitalization or not able to help with the patient discharge plan once they go home.

By offering your patients customized continued care after patient discharge, such as TriageLogic’s nurse triage plan, you will:

• Decrease ER readmission rates
• Ensure continuity of care
• Increase patient satisfaction
• Help patients avoid unnecessary ER visits
• Increase patient compliance with instructions

Nurses trained specifically for post-op care can help your hospital reduce readmissions by creating a customized follow-up plan to keep patients on the correct path to recovery. A hospital staff member will fax the post discharge nurse the instructions from the hospital EMR for patients that have been discharged and at risk for readmission. The nurses will make follow-up calls to confirm compliance with medications and screen for necessary follow up visits. If needed, TriageLogic nurses can also be available 24/7 for patients to call if a symptom arises. These calls can be customized to what the doctors think will work best and can be adjusted at any time.

The ideal program allows each specialty in the hospital to have its own custom profile in the system, so that each specialty can include custom instructions for the nurses to follow related to the care for specific procedures and specialties. Advanced systems, such as the TriageLogic Post Discharge system, can even create custom protocols to allow the nurses to ask specific and related screening questions. Some examples of these screening questions include:

Medication Compliance
Did you get medicines?
Do you know how to take them?
Are you taking them?
Do you have any concerns about taking the medicine?

Follow-up
When do you have an appointment scheduled?
Are you able to keep that appointment?

Symptom Review
Do you know what signs/symptoms to look out for?
Do you know what number to call if you have a medical concern?
Do you have any questions you would like me to pass on to your doctor?
Do you have any symptoms you are concerned about right now?

Interested in a post-op program for your hospital? Contact us for a turn-key solution customized for your hospital.

What Makes Us Different
In comparison to other patient follow-up models, TriageLogic has the most innovative technology and comprehensive system for your patient care. In addition to the customizable post discharge plan above, TriageLogic nurses also remain available for the patients 24/7 should any symptoms or questions arise. If your hospital is looking to reduce patient readmission rates, contact TriageLogic today to get a quote on the Post Discharge Follow-up service.

[1] Cloonan, Wood, & Riley. (2013) Reducing 30-Day Readmissions: Health Literacy Strategies. JONA: Journal of Nursing Administration. July/August 2013, Volume :43 Number 7/8 , page 382 – 387 

[2] FY 2017 Final Rule and Correction Notice Data Files. 

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