Post discharge calls have always been important for patient service and quality care. The need for this follow-up, though, has been gaining attention recently due to a new direct connection between patient satisfaction results and CMS payments. HCAHPS scores are likely to represent a percentage of annual Medicare payment in new hospital reimbursement formulas. For those hospitals that have not already been doing formal post discharge calls, the question is no longer "if" they should be done, but "how."
Many hospitals implement their post-discharge call program, in-house. There are a number of benefits to in-house call programs:
- Ready access to patient records
- Brand reinforcement
- Ability to involve members of the care team who delivered inpatient care
- Opportunity to identify or prevent adverse events before they escalate
- Possible increase of patient satisfaction scores and likelihood of referrals
Of course, there are drawbacks for doing the calls in house as well:
- Most reach only a fraction of discharged patients because other work gets in the way.
- Some hospitals can't staff the call center at night and weekends when discharged patients are most easily reached
- Inability to consistently staff the services with trained callers
- Creates an often unwelcome increase in staff workload
- Decreases staff's availability to attend to inpatients
In a perfect world-one where there is no shortage of time and no competing demands-the nurses who deliver care at the bedside would be the most likely people to follow up with patients after discharge. But, we're not operating in a perfect world. The reality today is that patients in the beds must take precedence over patients who have been discharged. Despite their best intentions, hospital administrators and nursing staff struggle to implement post-discharge phone calls that are completed consistently and that provide actionable information that is used to make process improvements that can impact patient care.
Because of both the challenges of creating and maintaining an effective post-discharge call program and the increasing importance of doing this critical follow-up, many hospitals are choosing to outsource the function. There are drawbacks to outsourcing as well, including:
- Initial unfamiliarity with hospital branding messages
- Lack of linkage with patient scheduling system (unless the call center handles this service as well)
- Calls may or may not be handled by personnel with sufficient medical knowledge
- Additional administration is required to report key data in patient records
But, more often than not, the benefits outweigh the potential drawbacks:
- Outreach programs can be run day or night, reaching discharged patients more effectively at times more convenient for them
- Reduced burden on hospital staff
- Cost efficiencies when compared to the costs of using hospital staff
- The use of trained callers with clinical experience
- An opportunity to identify or prevent adverse events before they escalate
- Results are immediately documented in a central, electronic location
- The implementation of a consistent process for patient follow-up and data collection across all discharge calling areas
Conducting formal, well planned and consistent discharge calls is important for individual patients and that's the number one reason for doing them. These calls are also important for your hospital and for future patients; that benefit is sometimes overlooked or unrealized. When calls are well managed, tracked and documented, hospitals are able to spot trends that may indicate either opportunities for process improvement or best practices that could be replicated throughout the hospital.