Safer strategies for patient care transitions
Thursday, October 11, 2018
Patient handoffs at every hospital are a constant fact of life — as an administrator, your aim is, of course, to make them as seamless as possible. Yet so many elements can go awry during any care transition.
If your healthcare workers don't utilize proper communication and procedural protocol, confusion and medical errors can occur, unfortunately.
Great news, though: the following research-proven strategies can protect your patients physically as they move from one provider to another, ease their stress levels regarding medical instructions and improve comprehension of their treatment.
Improve your organization's outcomes by:
Requiring residents to use face time.
A study by the American Thoracic Society found that monthly handoffs by residents leaving a clinical rotation can increase the risk of patient mortality. Computerized checklists are usually the way a departing resident informs the doctor taking his/her patients over about the specifics of cases — but this approach is not sufficient when it comes to providing a complete picture of a patient, or in terms of warning of potential, immediate medical problems, the researchers report.
A wiser approach: establish guidelines in which all interns and residents switching rotations meet face to face for a discussion with their patients' incoming team members, so all relevant details can be discussed. Require your residents to document this conversation in patient records as well.
Making patients active participants in shift changes.
Research from St. Michael's Hospital found that daily nursing transfers that take place at the bedside of patients lessens the chance that medication errors or treatment mix-ups will subsequently happen.
This is because when patients are present during care discussions, they're empowered to speak up about any mistaken information they hear exchanged; patients also can answer clarifying questions about how they feel, and state their concerns or care preferences clearly so that everyone is on the same page.
Passing on patient info completely.
A study from University Hospital Case Medical Center found that many PCPs aren't informed by hospitals that their patients have been admitted in the first place, and upon outpatient follow-up, are often not given adequate information on the care their patients received, or further treatment specifics.
Make sure your organization implements guidelines for alerting PCPs to admissions, sending all clinical records to each patient's PCP at discharge with their hospital care team's contact info, and directly scheduling PCP follow-up appointments for the patient.
This plan works: the study also found that out of 1,000 surveyed Medicare patients whose hospitals followed improved guidelines, re-admissions decreased from 14.12 to 11.52 percent.
Working more closely with rehabilitation centers.
Researchers from Johns Hopkins reported that the earlier and more frequently physicians and caseworkers talked prior to an elderly patient's transfer between facilities, the better that patient will do long-term.
Specifically, clear communication stopped medication errors like missed doses, and also allowed a rehab facility to provide that patient with more detailed education about their condition and recovery, so the patient will be ultimately able to practice good health behaviors when returning home.
Involving hospital pharmacists in patient discharges.
A study from the University of Southern California found that expanding the role of hospital pharmacy staff during the time a patient transitions from hospital care back to his/her PCP can lower hospital readmission rates by an impressive 25 percent.
Your pharmacists can reach out during the first thirty days after a patient's discharge to follow up on medication questions and ask about proper drug compliance; your pharmacists can also touch base with a patient's PCP, making sure patients are keeping follow-up appointments and taking any questions or concerns the PCP has back to the patient's hospital care team quickly, especially if that patient will be involved in outpatient drug administration like chemotherapy.
You can also monitor each patient's progress by checking in with the pharmacy team on a regular basis. Consistency is key — and will help each of your patients well reassured both physically and emotionally.
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