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3 Ways Discharge Folders Help Reduce Hospital Readmissions

Posted by Chris Higgins on Fri, Apr 18, 2014 @ 08:00 AM

Recent studies have demonstrated a disturbing trend in American health care: Patients are beingdischarge folders re-admitted to hospitals in large numbers, and in situations where the re-admissions were preventable.

According to the United States Department of Health and Human Services (DHHS):

  • Nearly 20% of elderly patients are re-admitted to the hospital within 30 days.

  • Only 10% of readmissions were planned.

  • Half of patients re-admitted had no follow-up care or consultation prior.

  • Two-thirds of unplanned readmission were due to adverse drug effects.

  • Overall, an estimated 3/4 of readmissions are preventable.

Obviously, anyone in health care should be concerned about these numbers simply in terms of patient outcome. Most of those readmissions represent a potentially life-threatening situation that could be avoided entirely.

However, the situation is even more costly than that for most hospitals.

The Real-World Costs Of Preventable Hospital Readmission

Every time a patient is needlessly readmitted, it costs your hospital money. In many cases, this is entirely a direct cost. For low-income patients, every hospital visit -or, worse, trip to the ER- is a bill that simply may never be paid.

Further, beginning in 2012, Medicare began fining hospitals that showed excessive thirty-day readmission rates, and fines can go as high as 3% of a provider's Medicare reimbursements. For hospitals with high readmission rates, this translates to a six-figure bill per year.

Ultimately, a hospital is looking at approximately $10,000-$15,000 in added expenses for every avoidable readmission. 

These costs don't even include the cost of substandard HCAHPS scores.

HCAHPS Scores Are Becoming Serious Business

The Hospital Consumer Assessment of Healthcare Providers and Systems survey began as a trial by Medicare, but has quickly grown in importance. These surveys, sent randomly to patients who have been admitted to a hospital in the last six months, are used to judge the performance of hospitals from a patient perspective.

At first, they were mostly for Medicare's benefit. As these scores have become public, however, they've quickly become a go-to source for decision-making among educated consumers "shopping" for doctors. In non-emergency situations, patients are increasingly likely to do this sort of research before going to a healthcare provider.

The idea of hospitals competing in a market environment may not be desirable for everyone, but it's the reality at the moment. Low HCAHPS scores may cost you patients who choose other providers, or potentially even scare away new staff.

While to our knowledge no study has yet attempted to precisely calculate the real-world dollars associated with such losses, it undoubtedly adds even more to the costs of needless admissions.

All this is merely meant to underscore the utter importance of reducing patient re-admission. This can be a win-win scenario, or a lose-lose scenario, based largely on nothing more than how much information the patient receives.

Three Ways Discharge Folders Create Better Patient Outcomes

As it turns out, both clinical trials and in-person interviews with patients have pointed towards a solution that should surprise no one: Patients who receive a thorough consultation and detailed instructions prior to discharge, combined with a comprehensive information packet, were vastly less likely to be readmitted.

In fact, readmission rates were nearly halved during trials at the Boston Medical Center, with nothing more than the introduction of these simple measures.

That's why custom-printed discharge folders may be one of the best insurance policies your hospital can invest in. At a cost of, at most, a few dollars per patient, dozens or hundreds of costly readmissions become preventable.

In terms of cost-effective solutions that guarantee improved patient outcomes, it's hard to hospital discharge folderimagine a better value.

1 - Send patients home feeling informed and secure with clear instructions.

In interviews, one of the most common complaints among discharged patients was that they simply did not feel their condition, prescriptions, and post-care were properly explained.

This situation is complicated by the number of post-op discharges going on. If a patient is still woozy from anesthetics or other medications, they may not be capable of understanding the directions given.

Such post-op patients may even be on strong painkillers for days into the future, further limiting their cognitive skills until their bodies heal and the pain ends.

Either way, a well-ordered patient discharge folder creates an exceptional teaching tool for doctors or nurses who need to quickly -but comprehensively- explain a patient's home care. Giving the discharged patient a complete, organized discharge folder with all the information they need to maintain their health and recovery after leaving the hospital greatly increases the chance they will understand and follow the crucial instructions that will keep them from having to return.

Plus, it's a fundamental pillar of education theory that visual references aid in learning and retention. When the staff members have specific detailed instructions along with visual references that the patient will keep, that patient is far more likely to remember and follow the discharge and home care plan.

Either way, it will send patients home feeling informed and confident about their care, which reduces their readmissions and improves their own morale in days ahead.

2 - Give patients an information package they will constantly reference.

A custom-designed discharge folder can be created to your hospital's specifications, with a wide variety of tabs, pockets, and other accessory-holders. If necessary, there's even room for a sleeve that holds a CD, DVD, or Blu-Ray with more supplemental material such as X-rays the patient can carry to all follow up appointments

Beyond that, it gives your patients a one-stop shop for anything they need to know about their care going forward. When it's arranged by topic, they'll be able to look up information for themselves, such as confirming whether something is or isn't on their dietary list.

The folder itself can even be part of the presentation and information. Printed maps, lists of emergency contact info, Frequently Asked Questions, or calendars with important dates are all possibilities.  You could even add promotional messaging for other services your location offers.

In addition to the utility in including these elements, there's a psychological factor here as well: When the package is all-inclusive, there's a lot more reason for a patient to keep everything organized in the weeks ahead.

3 - Create an effective roadmap to recovery.

One of the biggest challenges for home care is when a patient faces a roadmap that lasts weeks or months into the future. A person getting discharged in April is deeply unlikely to remember specifics about what they need to do in October without reminder.

In these cases, the accordion discharge folder can be arranged based on time, rather than topic. Section dividers marked by future dates create a clear and unambiguous route to patient recovery. When October rolls around, there's a tab that says "Instructions For October."

The simple presence of such a section will give comfort to a patient. They know ahead of time that the info they need is available when the time comes.

When combined with an effective pre-discharge consultation, this creates an informed and empowered patient who already has everything they need to know. This doesn't just reduce readmissions - it also potentially reduces extraneous consultations and clinic visits.

The Cheapest Insurance A Hospital Can Buy

Patient re-admissions are a big problem: they endanger people's lives, cost your hospital a lot of money, and ultimately threaten your reputation if HCAHPS scores drop as a result.

Yet, many of these readmissions can be avoided entirely through simple patient education. A few more minutes spent on discharge, accompanied by a robust custom-built take-home discharge folder, can potentially cut your readmissions by at least 50%.

When compared with the five- and six-figure bills associated with these readmissions, discharge folders don't merely deliver dollars-for-cents returns. The ROI is in the hundreds of dollars per cent spent.

With hospital costs a constant source of tension for everyone involved in the medical industry, these patient discharge folders create a simple, easy, and entirely practical solution. If you give your patients the information they need today, they won't be back in the ER tomorrow.

dataguide 3 ways discharge folders help reduce hospital readmissions

Topics: Document folders, document holders, discharge folders