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Three common challenges for post-discharge call programs—and how leading health organizations overcome them

Most healthcare leaders would agree that a comprehensive post-discharge call program would benefit their organizations. At the same time, many of them struggle to deploy one.

While the benefits are unimpeachable, the challenges of implementing post-discharge calls can be prohibitive for health systems—if they lack a strategic plan for roll-out.

Fortunately, some organizations have already achieved success. This post invites leaders to learn from their experience.

Here is a brief rundown of why post-discharge calls are important, what obstacles may arise in deploying them, and some solutions that NRC Health’s partners have discovered.

Why post-discharge calls

Post-discharge calls have much to recommend them. The evidence roundly declares that they bring important benefits to both health systems and their patients.

Cost controls

First, consider the financial case. Post-discharge calls are an effective way to reinforce care instructions, clarify medication confusion, and address any lingering clinical concerns. The aggregate effect of these benefits? Reduced readmissions.

This has a twofold effect on health-system balance sheets. Not only are organizations relieved of additional care costs, but they may also avoid CMS penalties for excessive readmissions.

One study in Population Health found that these effects together can amount to millions in savings for care organizations:

A stronger patient connection

Even more important than the effect of post-discharge calls on financials: their effect on patient relationships.

As , CNO at NRC Health partner Community Health Network, puts it, “Through post-discharge calls we can actually connect with our customers, and really feel like we know what they’re expecting.”

Organizations should not underrate the value of this connection. A phone call after the encounter is a profound way to signal genuine concern for the patient’s well-being. They help to expand the context of a patient’s relationship with their healthcare provider — which improves both patient satisfaction and long-term loyalty.

 

Better outcomes

Finally, and most importantly, there are the clinical benefits to consider. On this, the evidence is unambiguous.

In the event of a complication after a hospital stay, post-discharge calls give providers a crucial opportunity to intervene. A quick phone call enables them to identify any emergent issues and direct the patient to an appropriate resource for follow-up.

This ultimately reduces negative outcomes, leads to better quality of life after a hospitalization, and can even save lives.

What gets in the way

Small wonder, then, that health systems should be eager to bring post-discharge calls into the fold. But implementing these calls—especially at large, complex, or high-volume organizations—can be daunting.

Organizations face three significant obstacles.

The problem of volume

An ideal post-discharge call program will reach every patient who visits a facility. Most programs fall far short of that, and understandably: it takes an extraordinary commitment of staff hours to contact a meaningful percentage of discharged patients, let alone 100% of them.

Organizations, therefore, find themselves pressed between two alternatives. They can take on the financial strain to hire dedicated callers, or they can pass that strain on to existing staff, which may divert them away from other important work. For conscientious leaders, neither course is particularly appealing.

Departmental disparity

Further complicating outreach efforts is their lack of centralization. The task of reaching out to patients often falls under departmental responsibility. In any given organization, each department may approach the task a different way. This leads to disparate procedures being followed for making the calls, handling interventions, and logging the resulting data.

Central healthcare leadership are faced with several conflicting approaches, and must make difficult decisions about how to adapt departments to a singular standard.

Data overload

Then there’s the data to consider.

Documentation is a critical part of any post-discharge program. Callers need to record their outreach and activities, so that leaders can understand what’s happening in their organizations.

But the subsequent flood of data can quickly become unmanageable. Disparate data flows from each department may be difficult to reconcile. Documentary practices may be incomplete or error-prone. And even if leaders manage to obtain all the requisite data, they may still struggle to grapple with the sheer scale of the data-points in hand.

In other words: too much noise, and not enough signal.

Making post-discharge calls work

These formidable obstacles have stymied many post-discharge call programs before they had a chance to be effective. They can, however, be navigated by determined leadership.

Here are three ways that NRC Health’s partners successfully implemented post-discharge calls.

1. Start small

With two major hospital campuses, the University of Maryland Medical Center’s (UMMC) patient volumes were an imposing barrier to success with a post-discharge call program. UMMC’s leadership tackled the issue by starting with a plan for a staggered rollout.

They rolled out their post-discharge program to just 11 of the organization’s units. This gave them the ability to carefully organize their approach.“The project was a success from the start, because all the stakeholders were in the right place at the right time to take this project in the direction it should go,” says Shawn Hendricks, UMMC’s Director of Medicine and Cardiac Services.

From its humble beginnings, the post-discharge call program at UMMC has expanded across the entire organization—proof that a modest test-case can be an excellent foundation for future ambitions.

2. Automate

When it comes to call volumes, though, sometimes segmenting the organization isn’t enough. The number of patients that stream through a single department can be unmanageable for a health organization’s internal staff.

Sparrow Health found out as much when they tried to contact each patient after their episode of care. Even with 700 nurses trained to make follow-up calls, they only managed to reach 48% of patients at the peak of their efforts—with that percentage dwindling down to 13% in less than two years.

That’s why organizations like Sparrow Health turn to NRC Health’s Transitions solution.

Transitions is an automated platform that uses interactive voice recognition (IVR) technology to reach 100% of patients, within one day of discharge. This technology supplants the need for a small army of callers on a health system’s staff.

Once it contacts patients, Transitions also automatically identifies patients who may need extra clinical support, giving health-system personnel the chance to offer a hand.

This triaging of post-discharge concerns can make handling even enormous volumes like those at Sparrow more feasible. With an automated process, Sparrow was able to trim its calling staff from 700 nurses to just one—an enormous victory in scale and efficiency.

3. Utilize a single source of insight

Nor is that the end of Transitions’ utility. Just as important as its outreach efforts is the solution’s capacity to log and present data. Transitions seamlessly captures data from patient interactions and presents it all in a single, customizable dashboard for leadership to interpret.

This gives leadership unparalleled insight into their follow-up operations. Armed with robust data, they can make a detailed case for change and adjust their strategy with confidence—and even drive adoption and enthusiasm among clinical staff.

This data was instrumental for a host of operational changes at Hackensack Meridian Health.

“Having all this information from a single source gave us the opportunity to understand our customers better,” says Elizabeth Paskas, Hackensack’s Vice President of Human experience.

The path will vary; the destination will not

And that, in the end, is what Transitions positions health systems to achieve. Organizations arrive at a more complete understanding of their customers only when they broaden the context of their customer relationship, and push their grasp of the patient’s needs beyond the four walls of the facility.

Post-discharge calls are one way to achieve that, but they’re by no means the only one. Every organization faces unique challenges in drawing closer to their customers and sparking the authentic relationships that help both thrive. Whichever course your organization needs to take, NRC Health’s solutions, expertise, and experience will help you reach it.