Comprehensive Clinical Communication to Support Mother-Baby Care Delivery

Nearly four million babies are born per year in the United States.1 Obstetricians, pediatricians, nurses, case managers, discharge coordinators, and various other providers and care teams work to ensure that mothers and babies have optimal solutions for pregnancy, labor, delivery, and child healthcare.

From preconception to parenthood, PerfectServe’s comprehensive communication solutions can help your practice provide top-notch care at every touchpoint of mother and baby’s healthcare journey. Click the image below to download the infographic.

1Births and Natality, Centers for Disease Control and Prevention: cdc.gov/nchs/fastats/births.htm

To learn more about how PerfectServe can support your organization in mother-baby care delivery, contact one of our Clinical Communication Specialists.

PerfectServe Stands in the Fight Against Racism and Injustice

The murder of George Floyd on May 25—and the events that have transpired since then—requires deliberate introspection about the state of affairs in our country and beyond. These events are of deep concern to me, our employees, our families, our friends, and our communities.

The Black community is in pain, and positive change is a necessity. PerfectServe stands in the fight against racism and injustice. We stand to overcome the challenges that we face and use our voices to demand that ignorance and inequity come to an end.

It’s important for me to reassert that PerfectServe has zero tolerance for discrimination of any kind. We pride ourselves on creating a work environment that is equally welcoming to people of all races, genders, religions, sexual orientations, ethnicities, and nationalities.

In this moment, actions speak louder than words. We’re committed to evaluating our processes and standards—with help and input from people inside and outside the company—to ensure that diversity and inclusion play a larger role in PerfectServe’s culture moving forward. Change doesn’t happen overnight, but these initiatives will make us a stronger company and a better member of the community in the end.

This is only the beginning. We are confronted with daunting social challenges, and there isn’t a silver bullet. We can all do better, and PerfectServe is committed to being part of the solution.


Guillaume Castel
CEO, PerfectServe

National Nurses Week 2020

Annual celebration of nurses takes on special meaning during COVID-19 pandemic.

This week, businesses around the country, from Dunkin’ to Adidas to Chipotle to H&R Block, are clamoring to offer freebies and discounts for nurses to celebrate National Nurses Week 2020. Though it’s never a bad time to highlight the incredible work nurses do as vital members of care teams in healthcare organizations across the country, this year’s celebration feels especially poignant as the country (and much of the world) is still reeling from the effects of COVID-19.

PerfectServe is fortunate to have nurses on staff, including team members who still practice part-time today and others who transitioned into information technology full-time after spending years in nursing careers. With this valuable perspective in-house, we asked a few of these current and former nurses to share their thoughts about how COVID-19 has changed the role of a nurse, and which we’ll share throughout the rest of the week.

Julie Mills, RN, BSN, MBA

Julie-Mills-Photo

With 18 years of experience as a nurse, Julie has worked in many capacities sharing her clinical expertise, including in the US Air Force as a Unit Coordinator. Currently, Julie is a Senior Clinical Solutions Executive at PerfectServe, where she serves as a clinical advisor to teams across the company. She also practices at the University of Tennessee Medical Center and is pursuing her Doctor of Nursing Practice in Healthcare Administration degree at the University of Tennessee at Chattanooga.

Nurses are the listening ear, the conversationalist, and the hand holder.

“I’ve been a nurse for 18 years and currently practice a few days every month at an academic medical center that also serves as the region’s only Level I Trauma Center. COVID-19 brings a heightened sense of awareness to all that we do—checking temps when you walk in the door, wearing masks, and being mindful of supplies. Families aren’t allowed to visit, so they’re calling us more for updates about their loved ones, and the emotional support we provide becomes more critical to the patient.

Nurses have always been the primary patient caregiver at the bedside, but in a crisis, their role is expanded. Without families at the bedside, the nurse is the all day, everyday support system. Beyond providing care, nurses also step up to be the listening ear, the conversationalist and the hand holder. In rapidly changing clinical situations, the nurse’s clinical acumen and intuition are essential to managing care and communications with other team members.”

Mary Piepenbrink, RN, BSN, MBA

Mary-Piepenbrink-Photo

With more than 25 years of experience in the healthcare industry, Mary has served both as a nurse and a leader in information technology software and service solutions. Currently, she is the Vice President of Sales, Lightning Bolt, where she supports caregivers and helps hospitals and health systems improve their operations, reduce costs, and counteract provider burnout.

COVID-19: An Unprecedented Situation for Nurses

“This is unprecedented for most nurses; most do not have experience beyond routine infection prevention standards and practices. Some specialists mask, gown, and glove up when they care for known infectious patients, but typically that is a careful, thoughtful, measured approach. With COVID-19, nurses are doing this in long stretches and seeing patients rapid-fire. Nurses aren’t just concerned about the hard mental and physical work caring for patients they they normally do—they are fearful about transmission to other patients, concerned about the health of their coworkers, and of course have enormous stress about bringing the virus home to their families. As they do what they do best—triage, adapt, multitask, worry—I can’t but help wonder what effect this will have on our profession long term. I check in on my clinician friends—nurses, doctors, pharmacists—not just where I live, but in other more affected cities, to try and support them by listening and providing encouragement. Many of us feel helpless to do more.”

Mark Denny, BSN

Mark-Denny-Photo

Currently a Clinical Consultant at PerfectServe, Mark assists healthcare organizations as they implement PerfectServe’s Clinical Communication & Collaboration solutions. Mark worked in clinical informatics before transitioning to healthcare IT consulting.

Much-Needed Recognition for Nurses

“The presence of a nurse has a critical impact in any clinical setting, but even more so at this time. Right now, nurses are truly practicing the emergency alert responses they are taught and hope to never use. Nurses in general are frequently exposed to pathogens, bugs, volatile patient situations, staff shortages, and endless documentation, all the while going unnoticed for their work on a day to day basis. This crisis has brought to light many of the dangerous situations nurses willingly walk into every day, and they are now receiving the recognition they deserve. My work doesn’t take me to the bedside anymore, but my contributions make it easier for nursing staff to communicate with their co-workers and on-call physicians while making a positive impact on patient care.”

Celebrating National Nurses Week

For over 20 years, PerfectServe has worked hand-in-hand with nurses to improve care delivery workflows at hospitals and practices across the country. In fact, PerfectServe might not exist if it hadn’t been for the wife of founder Terry Edwards. Penny Edwards was a nurse handling inbound communication for a private practice, and her frustrations with the antiquated process for fielding patient messages and coordinating responses with the physician are what led Terry to devise a more modern after-hours answering service solution.

From those beginnings, PerfectServe has grown to serve healthcare delivery organizations of all shapes and sizes, and one thing that has never changed is the courage and dedication we witness every day from the nurses we serve. Happy National Nurses Week, and thank you for being the backbone of care delivery in communities throughout the United States, especially in times of crisis.

3 Ways to Save Nurses’ Time With Better Communication

nurse-time-perfectserve

Nurses play a central role in providing patient-centered, cost-effective care. They are responsible for care coordination and communication with each patient’s family members, as well as a growing care team of physicians and specialists, ancillary staff, and care coordinators. In addition to nurses’ growing list of daily nonclinical tasks, inefficient care coordination workflows prevent them from working to the top of their licensure.

A 2018 time and motion study revealed that in four hours, nurses spent around 32 minutes communicating with patients and family and 51 minutes communicating and coordinating care with members of the care team1—fully 34.6% of nurses’ time each day. Technology aimed at improving nurse workflows has often contributed to their frustration by adding siloed, task-specific “solutions” to their workload.

Let’s talk about the alternative. Keep reading to learn three ways clinical communication and collaboration (CC&C) technology can help healthcare organizations empower their nurses to work at the top of their license to drive patient-centered care for optimal outcomes.

Reduce Communication Cycle Times

Communication workflows are often cumbersome, requiring nurses to reference several systems and/or paper on-call schedules to page, call, and relay information through office staff … and then wait for the intended recipient to call back. This error-prone process causes care delays and requires a full restart when a provider is unavailable for any reason.

An improved communication strategy built around an integrated solution like PerfectServe can reduce average response times from 45 minutes to 20 minutes or less.2 Here are some key capabilities that can make it easy for nurses to find the right physician at the right time:

  • One unified directory to find and contact clinicians by name, role, and/or on-call status (e.g. “cardiologist on call”), or to send messages to the whole patient care team at the touch of a button.
  • Built in physician contact preferences to ensure communication is delivered via the preferred/frequently checked method.
  • Read receipts and smart escalation to ensure messages are read, acknowledged, and acted upon in a timely manner.
  • Message history and EHR integration for quick context.

Faster communication leads to safer, quicker, and higher quality care.

Integrate Alerts and Critical Result Notifications

Alarms, alerts, and other notifications continue to be named among the top 10 health technology hazards for 2020,impacting patient satisfaction and contributing to alarm fatigue.

In a 2015 study, nurses reported that only 52% of bed calls required nursing care, while others could be answered by support staff.4 Constant interruptions reduce care efficiency and require nurses to make multiple unnecessary trips to patient rooms. While nurses are inundated with too many alerts, they are not adequately alerted of critical results and orders, requiring them to repeatedly check the EHR for updates.

Centralizing alerts and communication across multiple systems, including the EHR and nurse call system, can eliminate noise, add context to alert notifications, and call attention to critical alerts by allowing:

  • Delivery of alerts to mobile devices, where nurses can accept, escalate, or call back to speak with the patient.
  • Push notification of critical results (lab or radiology) or physician orders to speed up time to care.
  • Routing of nonclinical alerts to patient care techs or nursing assistants.
  • Workflow rules to help ensure that only critical alarms disrupt normal workflows and are differentiated with a distinct alert tone.
  • Clinical surveillance to send push alerts for sepsis, respiratory deterioration, organ failure, etc.
  • Routing of “leads off” alarms to only alert the nurse assigned to that specific patient, set to escalate to the charge nurse if the assigned nurse does not respond within a predetermined time frame, eliminating an audible, ward-wide alert.

Simplify Patient Engagement

Nurses are tasked with keeping family members up to date on patient status, sharing care instructions, arranging discharge, and following up with patients and their families after discharge. As nurses invest increasing amounts of time in patient and family engagement activities, they become more confined to the nurses’ station and less available at the patient bedside.

Post-discharge patient engagement often relies heavily on phone communication, with declining impact due to phone tag and low voicemail retrieval rates. On the other hand, secure texting with patients and families allows health systems to automate more effective outreach in order to:

  • Share care instructions, arrange discharge, and answer questions.
  • Route inbound messages to the call center, rather than the nurse, for triage.
  • Automate patient outreach, such as surveys, post-discharge instructions (tailored to the patient profile), and referrals.
  • Support two-way communication and allow individuals to respond to patients as needed, leveraging the expertise of nurse assistants, call agents, and more.

Start Saving Nurses’ Time

PerfectServe’s CC&C solution with patient engagement capabilities helps streamline nurse workflows, reduce care delays, improve patient safety, and boost patient satisfaction. To learn more, contact us or click below.

PerfectServe’s Solution for Nurses

 

References

  1. Nurses’ Time Allocation and Multitasking of Nursing Activities: A Time Motion Study, AMIA Annual Symposium Proceedings, 2018: 1137-1146, Yen, P. et al., 2018: ncbi.nlm.nih.gov/pmc/articles/PMC6371290/#r34-2975707
  2. Secure Clinical Communications Makes Real Patient Impact, Health IT Outcomes, Griffith, A., 2015: healthitoutcomes.com/doc/secure-clinical-communications-makes-real-patient-impact-0001
  3. 2020 Top 10 Health Technology Hazards Executive Brief, 2020: org/landing-2020-top-ten-health-technology-hazards
  4. Interruptions of nurses’ activities and patient safety: an integrative literature review, Revista Latino-Americana de Enfermagem, Monteiro Cintia et al., 2015: ncbi.nlm.nih.gov/pmc/articles/PMC4376046

Preventing Patient Leakage With In-Network Referrals

In the shift to a value-based care model, healthcare organizations must deliver cost-effective, quality outcomes across the spectrum of care to individual patients and patient populations. To succeed under value-based care and programs such as the Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA), health systems have begun to consolidate. Consolidation allows healthcare networks to leverage technology innovation, share risk, improve care coordination, and offer greater patient access to clinical services.

With the rise of large healthcare systems made up of hospitals, primary care facilities, outpatient facilities, and ancillary services comes the opportunity to create a greater care team of providers from multiple facilities to support patient and population health efforts. Large healthcare systems are working to improve care coordination, reduce duplicate testing in the referral process, and create a system to support improved patient outcomes.

Patient leakage—when a patient seeks or obtains services outside the hospital network—makes it difficult to track and support patient outcomes. The onus is on healthcare leaders to reduce patient leakage to support value-based care.

The Cost of Patient Leakage

Every year, more than a third of patients in the US are referred to a specialist. Healthcare executives report the following:

  • 43% say they are losing 10% or more of annual revenue to patient leakage.
  • 19% say they are losing up to 20% of revenues.
  • 20% say they don’t understand where or why patient leakage occurs.
  • 23% of organizations neither track nor quantify patient leakage.1

Not only does patient leakage lead to lost revenue and increased coordination costs for the health system, it can also have negative impacts on the patient. With fragmented coordination outside of network, some specialists may not have full access to the patient’s medical records and history to support the referral.

One study found that approximately 70% of primary care providers (PCPs) reported sending patient history and reason for referral, but less than 35% of specialists report receiving that information.2 Inefficiencies in the referral process can result in denied referrals, delays in patient diagnosis or care, duplicate testing, and reduced continuity of care.3

20% of malpractice claims for missed or delayed diagnoses involved communication deficits in handoffs.3

Patient leakage occurs for a variety of reasons, but it happens most frequently when physicians refer out-of-network. While relationships may be one cause of these referrals, one study found that 80% of out-of-network referrals in a 700-physician medical group were attributed to a lack of understanding of the Accountable Care Organization (ACO) network.4 Making it easier to find in-network care providers helps health systems provide coordinated patient care.

Patient Satisfaction Contributes to Patient Leakage

On one side, healthcare organizations can reduce business losses from out-of-network referrals and improve care outcomes by making it easier to find and hand off care to in-network care providers. The second side of patient leakage is when patients choose to leave the healthcare network, which could be due to a lack of information about in-network options or issues with patient satisfaction.

With patients now assuming greater financial responsibility for their care, and the consumerization of medicine in general, patients may walk away with a referral but then choose a competing facility. It sometimes happens because the patient is dissatisfied with their current care or simply because, through research or reviews, they choose a competing facility with little awareness of the impact the choice will have on the coordination of their care plan.

Optimize Communication to Reduce Patient Leakage

To reduce patient leakage, healthcare organizations need to support in-network referrals and help ensure the right information is communicated to the right care provider at the right time. A clinical communication and collaboration (CC&C) solution can help with:

  • Unified Directory – Easily look up any member of the care team by name or by role. Referring physicians can look up a “cardiologist” to see a list of in-network cardiologists, with the opportunity to further refine the list by hospital or healthcare facility to best support patients.
  • Safe Patient Handoff – Referring PCPs or hospital physicians can perform a safe handoff to seamlessly share patient history and clinical notes with the specialist.
  • Coordinated Care – Support ongoing communication among the care team to foster team-based decision making and close the loop on the care plan.
  • Patient Referral Follow-Up – After discharge or referral, an automated message can be sent to patients to connect them with an in-network provider (if not already specified) to schedule an appointment and help increase the completion rate of referrals.
  • Patient Satisfaction Surveys – Surveys after each healthcare encounter can help organizations spot and potentially recover from dissatisfaction that can impact patient loyalty.

By focusing on reducing patient leakage, healthcare networks can help realize their value-based goals. To learn how to help support coordinated care and reduce leakage, contact us for a demo.

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Resources:

1 Patient Leakage: A new survey highlights high costs, limited control, Fibroblast, Oct. 2018: com/wp-content/uploads/2018/10/Patient-Leakage-A-new-survey-highlights-high-costs-limited-control-October-2018-1.pdf

2 Referral and Consultation Communciation Between Primary Care and Specialist Physicians, Finding Common Ground, JAMA Network, O’Malley, Reschovsky, Jan. 10, 2011: com/journals/jamainternalmedicine/fullarticle/226367

3 Dropping the Baton: Specialty Referrals in the United States, The Milbank Quarterly, Mehrotra et al., 2011: nlm.nih.gov/pmc/articles/PMC3160594/

4 Four Ways Healthcare Executives Can Reduce Patient Leakage, Managed Healthcare Executive, Vold, Dec. 8, 2018: com/business-strategy/four-ways-healthcare-executives-can-reduce-patient-leakage

 

The Role of Patient Engagement in Remote Patient Monitoring

remote patient monitoring

Remote patient monitoring (RPM) allows healthcare providers to monitor patients outside of the clinical setting. Particularly important for the management of chronic diseases, RPM is helping improve patient outcomes and reduce healthcare delivery costs.

Why Patient Monitoring is Critical

It is important to remember that patient monitoring is essential, especially when it comes to combating chronic diseases. By 2020, it is estimated that more than 40% of all the adults in the US (roughly 157 million people) will suffer from at least one chronic health issue such as diabetes or asthma; almost a quarter (81 million) will live with multiple chronic conditions.1

One of the best ways to treat chronic conditions is with regular and consistent treatment. However, the average American struggles with care plan adherence. Roughly half of all-American patients do not take their medication as intended; one out of five prescriptions are never actually filled. Medication non-adherence is estimated to cause 125,000 deaths per year. Poor medication adherence results in 33-69% of medication-related hospital admissions, with medication nonadherence costing the industry as much as $300 billion in direct and indirect costs every year.2

As of 2019, the Medicare fee schedule attaches reimbursement to general physiological remote monitoring of chronic conditions. This new schedule recognizes the value of patient-reported outcomes and RPM in improving health outcomes and reducing healthcare costs. According to KLAS Research, one-fourth of healthcare organizations say RPM reduces emergency visits and readmissions.3 Further, 13% of organizations report RPM improves medication compliance, 17% cite quantified cost reductions, and 25% report greater patient satisfaction.4

To effectively treat chronic illnesses, patients must adhere to a strict treatment regimen: taking their medications as prescribed and regularly attending follow-up appointments. As well as being a waste of clinical resources, a patient’s failure to attend their scheduled appointments (no-shows) often can be an early warning sign of care plan non-adherence.

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Text-First Approach to Patient Monitoring

Using cancer clinics as an example, many implementations of RPM and patient-reported outcome systems are tied to in-clinic appointments or discharge, but not all include routine outreach.5 In other instances, self-reporting RPM systems may be cost-prohibitive or lack integration with the hospital infrastructure required to support clinical workflow.

Healthcare organizations can leverage text messaging to collect data for remote patient monitoring and gather patient reported outcomes with simple surveys. Healthcare organizations can text a link to a secure web survey to assess wellness, pain levels, specific measures (e.g. blood glucose levels), or potential medication side effects.

Other clinical communication modalities are not as effective or efficient. Only 20% of emails are opened.  Patient calls from the clinical staff have a very high administrative cost. In comparison, text messaging is extremely quick to administer and 90% are read within 3 minutes of being sent.6

PerfectServe’s text-first patient engagement solution can automate the collection of RPM data and other patient-reported outcomes. Survey responses that pass a predefined threshold are automatically escalated to expedite early intervention. All messages support two-way text messaging with healthcare professionals and the option to invite patients into an encrypted channel for secure chat. PerfectServe customers report:

  • 70% ongoing response rate for patient health status
  • 0.9 point reduction in A1C
  • 12.6% reduction in no-show rate
  • 32% reduction in readmissions

Empowering patients to participate in remote monitoring activities improves patient care plan adherence and patient satisfaction alike. The net result improves outcomes and reduces costs.

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1https://www.nationalhealthcouncil.org/sites/default/files/AboutChronicDisease.pdf

2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234383/

3https://www.healthcaredive.com/news/remote-patient-monitoring-cuts-hospital-admissions-er-visits-report-finds/539073/

4https://www.healthcaredive.com/news/remote-patient-monitoring-cuts-hospital-admissions-er-visits-report-finds/539073/
5https://www.curetoday.com/publications/cure/2019/spring-2019/patient-heal-thyself-those-who-self-report-symptoms-may-live-longer

6https://www.voicesage.com/blog/sms-compared-to-email-infograph/

Elevating the Role of the Nurse to Support Value-Based Care

nurse value-based care

As healthcare has evolved toward a value-based payment model, we have seen many changes in how healthcare is delivered and by whom. We have seen progressive healthcare organizations embrace value-based care, shifting toward an interdisciplinary approach to care that leverages population health management, social determinants of health, and patient engagement to improve outcomes across the spectrum of care.

The role of the nurse elevates with value-based care. Nurses provide more patient-centered, efficient, and cost-effective care, from pre-appointment and intake to discharge and follow-up. In the primary care setting, progressive providers have increased patient access by conducting nurse-only patient visits during which registered nurses document patient histories, order lab or other diagnostic tests, and determine patient acuity.

To meet the increased demands of value-based care, nurses must work to the top of their licensure. Studies conducted several years ago indicated that, on average, nurses spend as little as 25% to 30% of their time at the bedside.1 On top of clinical workloads, nurses are responsible for care coordination and communication among an expanding care team. As the concept of the care team expands under value-based care to include nurses, physicians, therapists, and home care workers across multiple hospital and acute and primary settings, nurses struggle with the inefficient workflows associated with legacy communication devices and numerous clinical and communication systems.

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The key to supporting the elevation of the nurse is the elimination of activities that do not directly contribute to the health and well-being of patients. The incorporation of innovative technology can assist in this effort. For example, advanced communication technology can help nurses communicate efficiently with other members of the care team including those off-site, such as home health nurses and healthcare professionals at specialized hospitals, skilled nursing facilities, and wound care clinics. HIPAA-compliant secure text messaging can also take over many of the time-consuming communication tasks to prepare or follow-up with patients. The ideal solution helps reduce non-clinical tasks to allow nurses to focus their time on only those patients who need additional care.

PerfectServe’s clinical communication and care coordination platform addresses the inefficiencies of work processes and administrative tasks to allow nurses to assume a more significant role under value-based care, including:

  • Care Team Coordination – Collaborate with providers inside and outside the network. Connect with on-call care team members as a group, or by name or role such as “On-Call Cardiologist,” ensuring a nurse can reach the right physician at the right time to improve outcomes without the inefficiencies of referencing call schedules or playing phone-to-pager tag with physicians.
  • Pre-Appointment Patient Communication – Automate the communication of day-of-procedure information, appointment reminders, and wayfinding to prepare patients for upcoming appointments or procedures.
  • PostAppointment Patient Communication – Automate post-discharge communications to reiterate the care plan, send timely reminders (such as follow-up scheduling and prescription pick up), and assess patient health status and satisfaction with text-first survey questionnaires. Nurses can prioritize follow-up time to only those patients in need of clinical intervention.
  • Time-Critical Updates – Rather than force nurses to log into the EHR to check for results or orders, critical updates (orders and critical lab results) are pushed to the nurse and other care team members to speed up care coordination and delivery.
  • Real-Time Charting – A mobile, easy-to-use interface to access patient information and take notes, with text shortcuts, voice-to-text, and intelligent field mapping to reduce duplicate data entry.
  • Nurse Call, Alarms, Alerts – Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient.

By expanding the role and leadership of registered nurses and implementing improved processes facilitated by innovative technology, healthcare organizations can transform healthcare delivery, achieving improved efficiency and better outcomes at lower costs.

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1 https://www.healthleadersmedia.com/nursing/outsourcing-discharge-follow-calls-keep-nurses-bedside

Improve Patient Experience Before, During and After Care

improve patient experience

When it comes to communicating with patients, nothing beats the immediate connection of text messages. While email and phone calls face diminishing open and answer rates, 90% of text messages are read within 3 minutes.1

Combine the timeliness of texting with the relevance from patient context, and you have a powerful tool to communicate with a patient when and where it matters most. In this post, we will examine the opportunities to engage with patients across the spectrum of care, improve outcomes, reduce costs, and improve the patient experience.

Changing Patient Expectations

The healthcare industry has shifted from volume to value, working on the Triple Aim of improving patient populations, individual patient health and satisfaction, and reducing costs.2 At the same time as patient satisfaction is being linked to reimbursement, patient expectations for their healthcare experience continue to increase.

Patients, now responsible for a greater financial share in their care, are approaching their care experiences with consumer expectations. Patients expect convenience, personalization, and involvement in their care anytime, anywhere. With patient experience and satisfaction now moving targets, healthcare organizations need ways to engage patients in their care and to continually assess the success of their efforts.

Unfortunately, improving health system performance toward Triple Aim results has led to worrying rates of clinical burnout. With technology often cited as one of the leading causes of burnout, we are now seeing healthcare organizations focus on the Quadruple Aim, including provider experience and satisfaction.3 The Quadruple Aim recognizes the importance of usability, effective care processes, and improved clinical workflows to achieve Triple Aim results.

The patient engagement strategies below are designed with the Quadruple Aim in mind, reducing administrative burden with patient, population, and diagnostic-specific automations to engage with patients across the care continuum.

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Patient Preparation

How a patient experiences their healthcare encounter begins long before the patient even steps through your door. From their perception of your website and scheduling processes to your preparation and intake processes, patients are looking for modern, seamless, and informative experiences.

Healthcare organizations looking to transform their patient experiences can begin by engaging with patients before their scheduled appointments, including:

  • Care Preparation Instructions – reminders to fill or take prescriptions or start pre-operative instructions based upon procedure-specific pathways
  • Appointment Reminders – reminders of the date, time, and location of an upcoming visit with detailed wayfinding instructions
  • SDOH Support – leveraging social determinants of health (SDOH) data, reminders can include coupons for transportation to reduce no-shows
  • Patient Intake – send patients a link to electronic forms to support off-site check-in

In addition to automating preparation and intake, you can leverage automations to keep patients “in the loop” day-of-procedure. For example, scheduling delays can trigger a status message to patients to re-align their arrival time.

Hennepin Health, in partnership with Lyft, recently targeted patients with a history of clinic no-shows, allowing them access to a corporate Lyft account to get patients to their appointments. At the end of the 12-month trial period, no-show rates decreased an aggregate 27%, clinic revenue increased by $270,000, and ROI was 297%.4

During Care

Although the factors that influence a patient’s experience vary widely based on the reason and length of stay, we can follow the broad strokes of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to identify a patient’s perspective on their care experience.5 The 18 substantive questions included in the survey focus primarily on communication with doctors, nurses, and staff during care and at the critical point of discharge. Outside of this, questions focus mainly on environmental factors such as cleanliness and sound level.

PerfectServe’s clinical collaboration solution is designed to enable fast, efficient communication that enhances care and improves the patient experience.

Integrate Nurse Call, Alert and Alarm Notifications

We centralize communication across multiple systems onto a single platform to simplify clinical workflow while eliminating extraneous noise. Nurses receive alerts on their mobile devices and web apps, where they can accept, escalate for assistance, or call back to speak with the patient directly. If the call button is non-urgent (such as a “water” request), it can automatically route to the Patient Care Technician, reducing nurse interruptions. Patients benefit from reduced ward noise and faster response times – critical factors in HCAHPS scores.

Family Communication

Family members play a crucial role in supporting patients during their stay at the hospital and in encouraging compliance with care plans. Healthcare organizations are recognizing the importance of supporting families as part of the patient experience as well.

With pre-configured pathways, families can feel more comfortable leaving waiting room areas knowing that they will receive an automated message with patient status and return time. If a patient’s family member calls into the main hospital call center and are connected to the appropriate nurse, the nurse can return the call with one click. To ensure the correct on-call nurse is contacted in the future, the return call number is hidden.

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Post-Discharge Assessments and Surveys

Following the most recent round of Medicare readmission penalties levied against 2,583 hospitals, preventable hospital readmissions continue to be top-of-mind.6

According to a study published in BMJ Quality & Safety, patients reporting high satisfaction and good provider communication were less likely to be readmitted.7 Decreasing preventable readmissions requires that patients understand and adhere to their care plan, that pain is managed, and that follow-up care is scheduled and attended in less than two weeks.8

Post-Discharge Assessments

Leading hospitals are leveraging text-first interactions to monitor care, assess pain, and send care plan reminders (such as filling or starting a prescription). Questions can be delivered one-at-a-time to encourage response or patients can be prompted to a secure web form for a full survey or to share detailed personal health information. Frequent check-ins not only increase patient satisfaction but also allow clinicians to escalate concerning responses to a secure chat session or phone call.

Park Nicollet Methodist Hospital adopted a text-first follow-up program that included a series of customized follow-up questions to assess a patient’s risk for readmission. 70% of questions sent via text message receive a response rate from patients. The PerfectServe dashboard collects and analyzes every patient’s response and nonresponse, segmenting the patient population into risk categories and automatically flagging patients that need immediate follow-up.

Park Nicollet’s results showed that patients who received and responded to text messages were 32% less likely to readmit than those solely contacted by phone. (These results are risk-adjusted to account for the relative complexity of each patient’s conditions.)

Patient Satisfaction Surveys

The goal of any patient satisfaction survey is to gain honest insight into the patient experience. Although the HCAHPS survey has incentivized improvements in patient experience, the response rate for patients has been on the decline, down to just 26.7% from July 2017 to June 2018.9 Administered 2 to 42 days after discharge, surveys do not yield the timely data hospitals need in order to act on patient satisfaction.

Given the high impact of HCAHPS results on a hospital’s financial performance, there is an opportunity to survey patients before the CMS to mitigate issues and improve patient satisfaction in advance.

To make patient satisfaction surveys actionable, healthcare organizations need easy, customizable surveys that target specific patient populations and encourage meaningful dialogue. Surveys can be automatically triggered after the healthcare encounter while the experience is fresh on the patient’s mind. Deploying text message surveys and text-first surveys is a cost-effective approach to obtaining these coveted patient insights.

Patients indicating dissatisfaction present a service recovery opportunity – contacting them to show concern and learn more about their experience will not only inform systemic improvement opportunities but also will likely change the patient’s impression of the organization.

PerfectServe allows hospitals to reach patients and/or families in real time before, during, and after care to better engage, activate, and assess patients in their care experiences. Post-discharge assessments present an opportunity to evaluate patient satisfaction and address patient concerns while there is still time to directly improve their satisfaction.

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1 https://www.voicesage.com/blog/sms-compared-to-email-infograph/

2 http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

3 http://www.annfammed.org/content/12/6/573.full

4 https://patientengagementhit.com/news/do-rideshare-tools-reduce-transport-barriers-patient-no-shows

5 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Downloads/HospitalHCAHPSFactSheet201007.pdf

6 https://khn.org/news/hospital-readmission-penalties-medicare-2583-hospitals/

7 https://qualitysafety.bmj.com/content/27/9/683

8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369604/

9 https://patientengagementhit.com/news/hcahps-survey-non-response-bias-impacts-scores-practice-improvement

Improve Well-Child Schedule Adherence with Patient Engagement

well-child feature image

The medical system has long adhered to the tenets of value-based care in the establishment of the periodicity schedule for well-child visits. The American Academy for Pediatrics (AAP) recommends formal screening for infants through adolescence to chart growth and development and to provide early interventions for illnesses and injuries, which provides benefit to both children and the healthcare system as a whole.

“While the end goal of health transformation should be achieving the triple aim of improved health quality, improved population health, and reduced per capita health care costs, this requires investing more, rather than less, in primary, preventive, and developmental care. At no age is this truer than for children, whose health trajectories have health cost implications over decades and lifetimes.” – Charles Bruner, Ph. D., et al1

Unfortunately, adherence the well-child schedule is suboptimal, with rates diminishing over time – as low as 41% by the time the child is 15 months old.2 For children over age 6, well-child visits help ensure continued health, including assessments on growth, weight, sleep, or signs of physical or mental health issues.3 For children with chronic conditions such as asthma, evidence suggests that low well-child visit adherence rates are associated with an increased risk of hospitalizations.4

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The reasons behind low adherence rates are complex. Modern families face multiple time constraints, may not know about ongoing well-child visit needs, or may face social or economic challenges that impact their ability to adhere to the periodicity schedule. Pediatric professionals focusing on improving adherence to well-child visits can take a multi-pronged approach:

  • Well-Child Visit Reminders: encourage adherence to well-child schedule with automated reminders or suggested appointment timeslots
  • Social Determinants of Health: focus health promotion materials on family, community, and social factors, including links to community resources, transportation coupons, etc.
  • Pre-Appointment: send appointment reminders and preparation instructions, helping reduce no-show rates
  • Lower Readmissions: follow up with children recently released from hospital after injury or illness with automated assessment questionnaires and care plan reminders
  • Wellness Education: provide pro-active wellness information and links to appropriate community resources or educational material on your patient portal.
  • Chronic Condition Management: identify and track children with special health care needs, sending care plan reminders, ongoing encouragement, and periodic assessment questionnaires to parents to expedite intervention

PerfectServe can provide you pre-scheduled communications as well as two-way messaging to help engage patients and their families in positive health outcomes. PerfectServe’s Patient & Family Communication tool leverages SMS text messages, social determinants of health, and pre-populated workflows to identify patients and families who could benefit from well-child visit reminders, educational materials, or SDOH support. Unlike emails or phone calls, text message communications benefit from high response rates, allowing you to reach out to parents when and where it matters most. Parents can schedule an upcoming well-child visit, answer a wellness survey, or ask a question, with automatic alerts sent to the care team if a patient may need preventative support or outreach.

Working with one of the nation’s largest healthcare systems, we sought to improve well-child schedule adherence rates for children age 0-3 years old. Prior to the program, many well-child visits occurred up to a month after they should have, impacting immunization schedules and early prevention programs. PerfectServe’s Patient & Family Communication tool sent parents a reminder about well-child appointments, leading to 13% more pediatric well-child visits, a tighter adherence to the recommended schedule, and more participation in visits beyond infancy. The program had the benefit of also raising postpartum depression screening rates from 30% to 70%.

Contact us to learn how we can help improve your well-child initiatives.

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1https://www.mentalhealthamerica.net/sites/default/files/Commentary%20on%20Value%20Based%20Care%20final%20Nov%202017%20pdf%20%28002%29.pdf

2 https://www.ncbi.nlm.nih.gov/pubmed/30305388

3 https://health.usnews.com/health-news/patient-advice/articles/2016-02-23/why-older-kids-need-well-child-checkups-too

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551592/ ; https://www.sciencedaily.com/releases/2013/05/130524104642.htm

Lessons Learned from an Important Voice in Cross-Organizational Communication

Charting the most efficient path for critical patient communications within a complex care team is a tall order. When a large and complex team of care providers must work together—which is not a rare occurrence—communication breakdowns are all too common.

Mary Hatcher
Mary Hatcher, VP of Product Development
PerfectServe

Preventing these complex communication challenges requires forethought about the solutions required to move information accurately and efficiently from one care provider to the next. Mary Hatcher, Vice President of Product Development at PerfectServe, recently authored a guest blog about on this very topic for Healthcare IT Today. Here are some of the key takeaways:

  • Complex communication challenges most often occur immediately after discharge, when a patient is moving from the hospital to another setting, or with patients who have overlapping chronic conditions that require multiple specialists
  • EHRs are not equipped to solve the communication issues that frequently arise during complex care transitions
  • Healthcare organizations need a standardized communication process with tools and infrastructure that connect all members of a patient’s care team
  • The use of web and mobile applications facilitates real-time communication and collaboration across different care settings

To learn more, read the full article titled “How Clinical Communications Technology Connects the Care Team In Complex Cases” at Healthcare IT Today.