Reducing readmissions is top of mind for healthcare leaders across the country. With regulations changing, the financial impact of readmissions within a 30-day window pack a greater punch than ever.
In an effort to reduce readmissions — and post-procedural complications that could lead to invasive open-heart surgery — the Society for Cardiovascular Angiography and Interventions issued a statement in 2016 that scheduling follow-up appointments before cath lab patients are discharged is a process best practice that should be implemented.
The purpose of the cath lab follow-up appointment is to make sure that patients are complying with their medications, and to check the healing process of wounds and re-dress anything that may need attention.
According to Becky Newport, Nurse Manager at the Catheterization Laboratory and Cardiovascular Recovery Unit, University of Tennessee Medical Center (UTMC), “If we can get our patients to be compliant with their medications and wound care, then we’re in front of the complications and can hopefully prevent areadmission.”
The biggest key to getting early-on compliance from patients, though, is efficient and convenient scheduling of the follow-up appointment.
Scheduling follow-up appointments in a cath lab setting involves communicating with a few disparate entities. Nurses communicate with medical assistants in the cath lab to let them know which patients require a follow-up appointment, and with which cardiologist.
The medical assistant then contacts the cardiologist’s office to schedule the appointment — almost always by leaving a voice message. And then the wait begins for a callback.
Sometimes a game of phone tag ensues, leaving hours — even full days — between the time the patient is ready to be discharged and the time when the follow-up appointment is scheduled.
“At that point, it becomes a patient satisfaction issue as well,” Newport explained. “The patients are ready to go home.”
When patients get tired of waiting for their follow-up appointment to be scheduled, they leave; and the chances of them scheduling the follow-up appointment and showing up for it drop off rapidly.
“When patients miss follow-up appointments, it creates a potential financial impact for the hospital,” Newport said. “If there’s a circumstance that goes unnoticed or untreated because the patient didn’t come in for the follow-up, it could lead to a readmission. And having a readmission within 30 days of the procedure is going to have a financial impact on the hospital.”
The University of Tennessee Catheterization Laboratory and Cardiovascular Recovery Unit began using PerfectServe to coordinate the scheduling of follow-up appointments for discharge patients.
Used in more than 165 hospital systems like UTMC, PerfectServe is a secure clinical communications platform that expedites patient care by reducing call cycle times and promoting real-time collaboration between the extended care team.
Now, instead of conducting a series of calls that could take several hours to complete, medical assistants at the cath lab use PerfectServe to get appointment request details to the person available at that time to schedule the appointment.
They also initiated an automatic escalation process so that if the appointment request was not executed within 30 minutes, a higher-level supervisor is notified and can step in to get the appointment scheduled.
“So far, we have not had an instance where we were not able to get a follow-up appointment scheduled within 30 minutes,” Newport said. “Before PerfectServe, getting a follow-up appointment scheduled could take all day, and often the patients would simply leave without an appointment.”
Newport also said the cath lab has been able to track a significant reduction in the amount of time spent on coordinating patient follow-up appointments.
“We were able to reduce the number of phone calls going back and forth between our facility and individual cardiologist offices by 4,000 in the past year,” she said. “That’s 4,000 fewer calls, which has allowed us to improve efficiencies not only in our lab but in the cardiologists’ offices — so it’s been a win for both sides.”
Using PerfectServe to streamline a time-consuming and inefficient process has improved the working relationship between the cath lab and cardiologist offices.
“We’re working in a better environment now,” she said. “One where the demands of our jobs — which were causing response delays — don’t create more difficulties for us. PerfectServe has reduced the amount of work it takes to get our jobs done and made it easier for us all to work together.”
By allowing follow-up appointments to be scheduled in a reasonable amount of time and before the cath lab patient is discharged, Newport said, her group is able to more efficiently follow industry best practices.