A Texas Health System
A 168-bed hospital within the health system was suffering from high CMS penalties due to high readmission rates for CHF, Pneumonia and MI
2013
Post-Discharge Call Back Program for High-Risk Patients, EMR access and customized surveys
The hospital wanted to provide clinical check-ins for discharged patients, but leadership determined that providing this service with current nursing staff would be infeasible because the nursing staff was already working at capacity to care for inpatients.
The program included a RN call to each discharged patient within 24 to 32 hours of the patient leaving the hospital. The RNs determined whether patients were compliant with medications, had scheduled follow-up appointments, and understood or had questions about their discharge instructions. To determine potential areas of concern and to educate patients on condition management for high-risk patients, RNs asked questions about patients’ specific conditions. RNs clarified medications for patients and delivered real-time feedback to the hospital about patients who may be at risk along with other areas of concern.
The AccessNurse readmission reduction program exceeded the hospital’s anticipated results.
• $1.2M Savings due to 30-day readmits dropping 3% during the program’s first seven months (a 24% improvement and an estimated annualized savings of $2.1M)
• 49% Cost savings due to outsourcing the program and keeping nurses on the floor to provide patient care
• 42% Average increase in HCAHPS patient satisfaction questions resulting in a likelihood to recommend the hospital
• 3% Increase in follow-up appointment compliance
• 94% Of all needed interventions resolved by AccessNurse RNs with only 3% requiring escalation to hospital staff