The Challenge : Shrinking Budgets, Rising Costs and Greater Demand for Services
One area that has raised a lot of discussion is unnecessary or avoidable hospital re-admissions. This can best be defined as an individual who has had a hospital stay, are subsequently discharged but re-admitted a short time later. Sometimes this readmission is related to the health issue they were initially in hospital for or perhaps a new health issue that was ‘masked’ due to the initial concern. Either way, a readmission is costly to the health care system as well as to the individual in terms of their health and emotional well-being.
Discharges from hospitals often create information overload. Health care workers do the best they can to prepare the patient for the next phase of their recovery but this system seems to fail far too often. To put it quite plainly, often there is no system in place to prepare the person as the patient or for health care staff to follow for what they will experience once getting home. Patients are dealing with the emotional aftermath of health crises and hospital staff is dealing with mounds of paperwork requirements, time constraints and sometimes under-staffing. In the end, the patient is often left to his or her own devices with little effective discharge support.
There can be many reasons why hospital re-admissions occur: Inadequate relay of information by hospital discharge planners to the patients, their caregivers and post acute care providers; poor patient compliance in terms of follow up appointments and care instructions; Inadequate follow-up care by post acute and long-term care providers; deterioration of a patient’s condition; medical errors; or the lack of a culture within the hospital environment that engages effectively with the broader organizational community to activate and engage all external resources to support the patient. Irrespective of the reason, hospitals need to look at innovative ways to effectively engage and communicate with patients and caregivers the importance of and the resources available through the discharge, support and follow up processes to effectively avoid readmission and meet the needs of the patient.
Understanding the Challenge: Walk a Mile
To clearly demonstrate and understand the perspective of the person in the Hospital bed, staff would benefit tremendously by having to spend a day in the patient’s shoes or should I say bed, to truly understand and appreciate what a patient goes through and where the gaps in the process and communication are. An organizational culture built around understanding, acceptance and seeing the person is critical to a model that reducing costs and enhances service, experience and well-being. At Manzimvula Ventures, we work with health care organizations on two fronts. The first is initially at a personnel or staff level before we expand to a stakeholder level, to identify opportunities in communications, culture, community engagement, and the family, friends and caregivers around the person leaving hospital. The second area is in helping the organization and its teams at different levels to identify areas and systems that need enhancing to help them achieve their part in lowering costly re-admissions. We can effectively improve their re-admissions rates all the while keeping the focus on the person as the patient in ensuring his or her needs are being met and that the hospital has an effective, streamlined system that hospital staff can easily adopt and follow. By engaging at a personal level with the person as the patient, staff and caregivers understand needs, limitations and opportunities to support the person in their home environment, thus reducing re-admissions.
Steps in the right Direction: A Process of Change
In the United States: On March 23, 2010, President Obama signed into law comprehensive health care reform legislation, the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health Care and Education Reconciliation Act (HCERA; P.L. 111-152). The legislation contains a number of provisions that make changes to Medicare. Among these are provisions intended to reduce preventable hospital re-admissions by reducing Medicare payments to certain hospitals with relatively high preventable re-admissions rates. The cost of not creating a discharge and follow up system may become very costly to hospitals. Now is the time to evaluate what is currently place and how you make your organization more patient friendly and engage the broader community at a deeper more effective level to create the Win-Win environment. A long way to go yet, but steps in the right direction for the person as a patient.
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Manzimvula® is a values-based as a consulting practice and a Certified B Corporation, and specializes in sustainability and corporate responsibility. To stimulate ingenuity and create growth, we work alongside our clients, guiding them through our Purposeful Path to Sustainability Program™ utilizing our Integrative Strategy Approach™ to help them engage their organization at a deeper level to understand mindset and create alignment with core strategies and principles.
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