By Karen Brown, RN

Readmission prevention continues to be at the forefront of hospital system interest in medical call centers, understandably so in view of recent studies that claim approximately 27% of all readmission are preventable. There are a number of factors related to readmission such as hospital acute care dynamics, various discharge procedures and an understanding of the immediate post discharge period.  Recent studies indicate that these factors and thus the challenges of the post discharge phase are most effectively addressed with a post discharge phone follow-up.

These calls may be a one-time occurrence based on analytics of the disease process or may occur at regular intervals for 30 days to ensure the patient is compliant with the plan of treatment and has received a follow up visit. Considering that the majority of patients 64 and older do not understand re-dosed, stopped, or new medications given at discharge, medication reconciliation needs to be a focus of these post hospital calls.

Medication reconciliation involves developing an accurate list of post hospital medication and assessing that the patients have all the prescribed medications in the home. Patients need to be reminded to put old medications out of sight. The home environment is the best place for the patient to learn the “what, why and how” of their medications as well as their complete plan of care. Who better to educate and engage a patient then an RN who is focused on that patient and has been trained in the art of telephonic assessment.

TeamHealth Medical Call Center believes that the experience and technology that we have invested in our post discharge programs have created the hospital bridge to keep patients out of the hospital and at home and engaged in their care. This is clinical excellence that follows the patient all the way home.

 

Karen Brown, TeamHealth Medical Call Center Leadership, VP of Business Development

Karen Brown, RN

Karen Brown, RN, is the VP of Business Development for TeamHealth Medical Call Center.