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Discharge Phone Calls Nearly Double Patient Satisfaction
By Nina Setia and Christina Román |
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hile HUMC underestimated the time it would take to hardwire implementation of some Studer Group Must Haves®, one tool that delivered dramatic results quickly |
and consistently to patients was discharge phone calls. |
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Roll Out
HUMC’s Satisfaction Advisory Council developed and rolled out discharge phone calls using a customized protocol with different criteria for inpatient, outpatient, emergency/trauma department and other settings. Since research shows that most adverse events take place within 48 hours post-discharge, HUMC calls patients within eight, 24, or 48 hours depending on the setting. |
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| Because HUMC has high occupancy and volume, it was important that patients felt ready for discharge, and not rushed out of the hospital. Discharge phone calls also address key research findings. In fact, not understanding discharge instructions is one of the top eight ‘dissatisfiers’ to patients. Research also indicates that how the patient manages their recovery post-discharge is vital to maximizing clinical outcomes. |
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In April 2006, HUMC decided to test the impact of the calls on patient perception of care by adding a question to its emergency/trauma department patient satisfaction survey, administered by Press Ganey: “Did you receive a follow-up phone call the day after your visit?” Initial results in second quarter 2006: a difference of more than seven mean points in how well patients understood discharge instructions, which represents the difference between a ranking in the bottom quartile or a ranking in the top decile of the Press Ganey ED national database.
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The Process |
 Click here for a larger graph. |
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Results Get More Results
When these results were shared with staff, they became more committed to making the calls. Calls were up 15 percent in one quarter, thus reaching more patients. In July 2006, HUMC added the discharge phone call question to inpatient and other surveys. By drilling down and analyzing the data on the question by unit, HUMC was also able to identify individual coaching opportunities. A key learning: the quality of the calls was more important than the quantity. Because the purpose of the calls is clinical with a service component, it’s critical that nurses or doctors make them, rather than patient advocates or other non-clinical personnel. |
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| In April 2007, HUMC added another innovation for even more momentum. They implemented Studer Group’s Discharge Call ManagerSM software as a way to further accelerate outcomes and hardwire tracking and accountability. |
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| In the end, the data tells the story. Patients who feel comfortable about how to manage their care when they leave the hospital are more likely to perceive their care as better. This is the difference between being an average player in the healthcare marketplace and the best in the nation from the patient’s perspective. |
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| How can you not do discharge phone calls when you see results like these? Discharge phone calls are clearly a best practice in serving patients, ensuring clinical quality, and building a reputation as an industry leader. |
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Discharge Phone Calls Are Effective |
Click here for a larger graph.
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Patients Who Recieve Discharge Phone Calls Are More Likely to Recommend |
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Hourly Rounding: Lessons Learned |
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In February 2006, HUMC rolled out hourly rounding on patients to nurses at a staff meeting. Because nurses perceived it as just another “to-do”, there was limited compliance with the rounding protocol and little resulting increase in clinical and quality outcomes.
But HUMC was also in the process of reorganizing its Professional Practice Council to create more shared governance and foster more bottom-up decision making by staff nurses. It was then that some council leaders offered guidance on how to make hourly rounding work.
“Staff nurses suggested we incorporate expected behaviors into our care delivery model for patientcentered care,” explains executive vice president and chief nursing officer Dianne Aroh, RN. “This embedded hourly rounding in the organizational culture. HUMC also invited Dr. Chris Meade, author of the Alliance for Healthcare Research’s ground-breaking call light study, to share her findings so nurses could connect hourly rounding behaviors to improving clinical outcomes for patients.
“When our unit moved to a new building, I used it as a fresh start to recommit to hourly rounding,” explains |
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Dena McDonald RN, BSN, nurse manager on a women’s surgical unit at HUMC. “The turnaround came when our Studer Group coach Karen Fraser re-presented the concept at our staff meeting and connected us back to why we went into nursing—to deliver quality care to patients. We talked about the difference between “checking” on patients versus asking if pain, potty, and positioning needs are met. We made hourly rounding the number one focus in our work.”
As a result, McDonald’s unit soared from the 39th percentile in pain control in the second quarter of 2006 (Press Ganey) to the 90th percentile in the second quarter of 2007 when compared to the unit’s specialty nationally. Answers to “nurse’s attitude toward your request” jumped from the 28th to the 85th percentile in one year. “When we checked patient perception of care through Discharge Call Manager, 96 percent of patients said they had been seen every two hours or less,” adds McDonald.
HUMC continues to hardwire hourly rounding on all units, but early results are positive. Patient falls in the first three quarters of 2007 are down by almost 10 percent for an annualized return on investment of $532,000. |
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Hear Discharge Phone Calls Expert Joseph McCrory |
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Studer Group’s discharge phone call expert makes the case for the calls. Watch the three minute video by clicking here. |
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