May is Mental Health Awareness Month. As advocates and providers work to address the stigma surrounding mental health topics, there are ongoing regulatory changes that are shifting the healthcare industry towards integrated approaches to patient-centered care. Over the last decade, healthcare has undergone a major transformation to incentivize collaboration across specialties and settings. This has sparked a movement towards considering clinical, physical, and social needs holistically and prioritizing the best ways to assess, diagnose, and address behavioral health needs.
New regulatory incentives at the federal and state level have freed up funds that enable further collaboration among various providers. Value-based payment contracts between health systems and Managed Care Organizations have placed a deeper emphasis on enhancing collaboration, removing silos between care settings, and integrating community-based resources with clinical services. With centralized care management teams that span multiple provider organizations, these resources can better manage care and focus on addressing social determinants of health.
Breaking down the silos in healthcare and integrating primary care with mental health and substance use disorder services are an important first step in proactively identifying patient needs and coordinating care to address and resolve any potential issues. When provider teams address care delivery with a focus on the whole person behind the patient, they will be equipped to improve outcomes and in time, lower the total cost of care.
As we look towards the future, the next step is finding ways of enhancing collaboration by providing interoperable solutions that will remove the need for duplicative data entry and optimize limited labor resources, meet patients where they are, and further advance the progress in providing care that considers the whole person. With value-based care, providers are incentivized to look at the patient more holistically and treat more than just a symptom or condition.
For more information on mental health in the United States, please access these resources:
While providers often search for the secret to effective care management and patient communication, Romano offers simplicity in the answer: Listen to, understand, act on, and then resolve patient concerns. Patients deserve the highest quality of care, delivered in a way that meets their personal needs and preferences.
Romano elaborates on the need to integrate patient preferences into the plan of care by stating, “No matter how busy you are — the patient doesn’t need to feel rushed — let the patient know you are their advocate, that you care, and will make sure they are taken care of. Once the patient feels that caring message, it is critical that follow-through occurs or they will lose trust.”
The Impact of Trust on Patient Loyalty
As providers across the country celebrate this year’s Patient Experience Week, keeping this in mind will ensure patients are satisfied with their care experiences. The trust that patients develop with their care providers will have a direct impact on the ability of healthcare organizations to remain competitive in the changing healthcare landscape.
“We must earn loyalty through exceptional service both clinically and emotionally. We must earn that patient’s trust and never lose it. We must keep them safe and make sure they feel respected as a person and that we care. When that happens, there will be no one more loyal than the person on the receiving end,” Romano concludes.
Every flight starts with the standard three-minute safety demonstration, complete with seatbelt and life vest props. During the demonstration, flight attendants inform passengers that in the event of a sudden decrease in air cabin pressure, oxygen masks will drop from the ceiling. Flight attendants explicitly instruct passengers to put their own oxygen masks on first, prior to assisting others. These safety instructions provide an important lesson for all individuals in helping professions: in order to help others, you need to take care of yourself first.
In my experience, most healthcare professionals pursue healthcare as a career to help others. To provide the highest quality of patient care, we must also care for ourselves and our peers. Attaining joy in our work is necessary to ensure optimal patient outcomes.
Prioritize Self-Care to Achieve the Quadruple Aim
In 2007, the Institute for Healthcare Improvement (IHI) developed the Triple Aim framework to support healthcare organizations in navigating the shift from reactive healthcare to the proactive improvement of health for individuals and populations. Since then, the Triple Aim has been expanded into the Quadruple Aim, as many healthcare organizations have identified restoring joy in the workplace as a prerequisite to enhance the experience of care for individuals, improve the health of populations, and reduce the per capita cost of healthcare. In fact, the President of the IHI recently shared, “Staff are much more likely to be enthusiastic and positive about securing the best outcomes for patients when they feel supported, empowered, and respected.”
According to a recent Discussion Paper published by the National Academy of Medicine, burnout is characterized by “…a high degree of emotional exhaustion and high depersonalization, and a low sense of personal accomplishment from work.” Due to significant changes in how care is provided, documented, and reimbursed, the evolving healthcare environment is a major contributor to burnout. Healthcare professionals experiencing burnout adopt attitudes that lead to lack of engagement and loss of connection at work. They may feel that patients are asking unreasonable requests, team members do not listen to their concerns, and their place of employment does not care about their experiences. As such, the National Academy of Medicine identifies burnout among healthcare professionals as a threat to safe, high-quality patient care.
Leverage Proven Strategies to Reduce Burnout
As healthcare professionals, what can we do to ensure that we feel supported, empowered, and respected? As current and future healthcare leaders, how can we take better care of ourselves and our colleagues as part of our organizational commitment to the Quadruple Aim?
The Green Cross Academy of Traumatology developed Standards of Self-Care Guidelines in recognition that only those that first care for themselves can provide the highest quality of care for others. As an ethical principle, the Academy maintains, “…the duty to perform as a helper cannot be fulfilled if there is not, at the same time, a duty to self care.”
The University of Buffalo School of Social Work provides a number of resources for self-care, including a Self-Care Starter Kit developed by Lisa Butler, PhD. Although there is no one-size-fits-all approach to self-care, important elements include managing and reducing stress, taking care of physical health, honoring emotional and spiritual needs, nurturing relationships, and finding balance in personal and work life. According to Butler, “…each person needs to identify what they value and need as part of day-to-day life (maintenance self-care), and also identify the strategies they can employ if and when they face a crisis along the way (emergency self-care).” For some, this may mean that we need to seek, find, and remember appreciation from our supervisors and clients. For others, it may mean physically exercising regularly, enjoying the outdoors, and engaging in self-reflection.
As healthcare leaders, take the opportunity to conduct proactive rounds on front-line staff at all levels of the organization. Both formal and informal check-ins are a great way to ensure that your team members connect to their day-to-day work and have the adequate resources to take care of themselves and their patients. Recognizing the achievements of your colleagues can go a long way towards reinforcing what is important and boosting morale.
To achieve the Quadruple Aim, staff must perform at their very best every day. By developing self-care strategies that include expressing and experiencing gratitude, healthcare professionals can become more proactive in the prevention of burnout. As we celebrate Patient Experience Week, take a moment to review your own self-care plan. For your own well-being and that of your patients, you will be grateful that you paused, took a breath, and reflected upon your role in providing the best possible experiences for all patients.
To learn more about how healthcare organizations can improve the patient experience across the continuum of care, we recommend these resources:
For OSF St. Mary’s, rounding is not just a task to check in with patients; it is a form of connection, accountability, and improvement across the organization. As we have explored, leadership rounding is an essential component in improving patient and staff satisfaction, and this is especially true for OSF St. Mary’s.
Promoting Quality and Coordination Across the Care Continuum: An Interview with Edgewood Place Skilled Nursing Facility on Technology in the Post-Acute Care Environment
In today’s increasingly connected world, it is becoming a standard industry practice for hospitals to interact with patients using technology. With CMS reimbursements now tied to patient satisfaction and quality measures, hospital leaders understand the importance of using technology to capitalize on payment reform. More recently, post-acute care (PAC) providers, including skilled nursing facilities (SNFs), home health agencies (HHAs), and inpatient rehabilitation facilities (IRFs) have turned to technology to comply with similar regulations.
To promote care coordination across the continuum, CMS will soon require PAC providers to standardize and report on quality, outcomes, and satisfaction. This increased transparency pushes PAC providers to improve the experiences of patients and residents, optimize care services, and reduce readmissions. Using hospitals as a model for success, it is clear that technology will be a key factor in this changing PAC landscape.
Recognizing this shift, Edgewood Place at the Village at Brookwood, a skilled nursing facility part of the Cone Health System in central North Carolina, has turned to innovative technology to improve residents’ experiences and outcomes. Edgewood recently partnered with CipherHealth to implement CipherOutreach, a post-discharge follow-up calling platform, and Echo, a digital tool to record personalized discharge instructions. This collaboration demonstrates Edgewood’s mission to keep residents healthy and happy long after they leave the facility.
Steve Swanson and Teresa Pennington, Administrator and Administrative Office Manager at Edgewood Place, spoke with CipherHealth about how they are strategically implementing technology to improve the care experience and prepare for payment reform.
Interview with Steve Swanson and Teresa Pennington
CH: As you were making the decision to implement CipherOutreach for your follow-up calling program, what were the primary challenges that you were trying to address? What specific goals did your organization have when partnering with CipherHealth?
Edgewood: Our goal when implementing CipherOutreach was to receive feedback from residents about our care services and quality in a direct way. We partnered with CipherHealth not only to receive this important feedback, but also to have a better, more streamlined way to address any issues that residents may have related to their care. This program quickly became an essential component in providing high-quality care services.
CH: What have been the residents’ reactions to the automated calls?
Edgewood: The residents have been extremely responsive to the follow-up program. Through the reports we receive from CipherHealth, we see that the majority of our residents complete the entire CipherOutreach call, and when callback is required, tend to be very honest with our staff. This allows us to address issues before they lead to adverse events, such as hospital readmissions. This proactive issue resolution also helps increase resident satisfaction and boost referrals.
CH: Was implementation of the calling system difficult?
Edgewood: From the beginning, the calling program was very user friendly and easy to implement. Should we experience any difficulties, the Cipher team is always available and eager to lend support to ensure that we are comfortable with the technology.
CH: What have you learned about your residents through the CipherOutreach and Echo programs?
Edgewood: We have learned that many residents do not fully understand their discharge instructions at the point of discharge, but may not speak up at that time. Despite this initial apprehension, residents tend to acknowledge that they need help on the CipherOutreach calls. Our staff is automatically notified of these issues or questions, and we can intervene prior to the residents making a medication mistake, improperly managing their care, or returning to the hospital.
CH: What are some of the successes that you’ve seen since implementing CipherOutreach and Echo?
Edgewood: By spotting trends in residents’ behavior and issues reported, we have been able to address several challenges that are typical of SNF residents post-discharge, for example, helping them obtain DME, Medications, and O2. CipherOutreach and Echo have also allowed us to promptly answer medication and therapy questions to prevent mistakes that could lead to hospitalizations.
CH: Can you speak to the value that you see in Echo, the digital discharge instruction recording tool, specifically?
Edgewood: With the Echo program, residents have the option to go back and listen to discharge instructions as many times as they would like at their convenience. This helps ensure that residents understand their care plans and comply properly with instructions. We’ve seen that the residents who listen to their Echoes have required fewer manual callbacks or interventions from staff.
CH: What is the role of innovative technology in SNFs, as players in the industry work to position themselves as a value-base partners to their referral sources?
Edgewood: Innovative technology is the most effective way to consistently receive meaningful feedback and drive improvements. We see the direction that medicine is moving in, and we believe that care does not end when a patient or resident walks out your door. We aim to offer high-quality care from the beginning of a resident’s experience to the end. Care must be coordinated at all levels, from hospital – to SNF- to Home Health – to outpatient – to independence, and on. We must work to prevent readmissions and additional expenditures to the referral sources, insurances, and the patients.
As highlighted by leaders at Edgewood Place, care extends far beyond the point of SNF discharge. Arguably, the window immediately after a patient or resident returns home or transitions to a lower acuity care setting is the most important time for providers to reach out. Having a robust discharge process including patient or resident follow up helps to prevent avoidable complications and hospitalizations, and creates a positive, lasting impression of the care experience. For Edgewood, incorporating CipherOutreach and Echo has allowed the organization to better understand its residents and make informed changes to improve quality of care and outcomes.
To learn how your organization can partner with CipherHealth to improve quality of care and outcomes, and prepare for payment reform, contact us today.
The Comprehensive Care for Joint Replacement Model (CJR), CMS’ first mandatory bundled payment initiative, started on April 1st. The five-year program is mandatory for about 800 hospitals in 67 geographic regions. Becker’s Hospital Review has outlined 13 things that healthcare leaders must know to comply with and capitalize on this payment model, and avoid financial penalties.
CipherHealth’s digital solutions help hospitals succeed under CJR by coordinating care across different providers, and by enhancing the discharge and care transition processes. To learn more about how our products drive compliance with CJR, download our overview or view our slideshow.
Over the last thirty years, patient-centered care has gone from being merely an idealistic concept to a fundamental and expected approach to care delivery. Today, Planetree, a non profit organization, leads the charge in the advancement of such care practices. In this series, we discuss and disprove the myths that Planetree has identified as challenges to achieving patient-centered care.
Before debunking these myths, it is important to explain what we mean by “patient-centered care.” As defined by the Institute of Medicine (IOM), it is “providing care that is respectful and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” In short? It means taking the patient into consideration when making clinical decisions.
Today, we address the following myth: Providing patient-centered care is too costly
Don’t I need to spend money to make improvements?
It is a common misconception that in order to become engrained in everyday practice, patient-centered care requires costly initiatives. While some hospitals have made large investments to enhance the patient experience, providing care that incorporates patient and caregiver preferences stems more from an organization’s attitude and culture than its resources or equipment.
Culture Change is Free.
Empowering staff members to make the most of each patient interaction is much more valuable than simply hiring more staff members or purchasing commodities to “wow” patients. Additionally, many hospitals have successfully implemented volunteer programs to enhance their offerings and provide additional support for patients at little to no cost.
Initiatives such as employee engagement rounding and volunteer training drive positive culture change and ultimately improve patient satisfaction, quality of care, staff satisfaction, and staff retention. Such programs do not require heavy financial investments, and any costs are quickly offset by the benefits provided. In the end, by enhancing the quality of patient care, these efforts can lead to revenue growth through higher HCAHPS scores and VBP bonuses.
For more information on debunking the misconceptions of patient-centered care, visit planetree.org.
For the ﬁrst time, CMS is making bundled payments mandatory for hospitals with the Comprehensive Care for Joint Replacement (CJR) model, set to begin April 1st. The program holds hospitals and their collaborators accountable for costs, complication rates, and quality of care for patients undergoing hip and knee replacements.
What is the purpose of CJR?
Hip and knee replacement surgeries are the most common procedures among Medicare patients, with hospitalizations alone costing more than $7 billion annually. With these patients receiving care from several providers, it is essential to coordinate care across the hospital and post-discharge environments.
CJR aims to enhance care coordination by holding approximately 800 hospitals in 67 geographic regions ﬁnancially accountable for a 90-day risk-window, including all post-acute costs. CMS will set a pre-determined target price for an episode of care. If the hospital’s spending exceeds this target, the facility pays the excess cost to CMS. In contrast, if the total episode cost is below the target, CMS reimburses the hospital the difference as a bonus.
What does CJR mean for PAC providers?
While CJR seems to impact only hospitals, the primary opportunity for hospitals to increase gain or decrease loss will occur in the post-acute care (PAC) setting. On average, 45% of all episode payments occur post-discharge. For this reason, hospitals are going to form networks and enter risk-share agreements with PAC providers that have proven to provideefficient, high-quality care. Specifically, hospitals will consider:
Home Health Compare and Nursing Home Compare (Star ratings and quality metrics)
Historical Medicare Payments
How Can PAC Providers Prepare?
To succeed under CJR and share in the rewards of the program, PAC providers must work towards better care coordination and transitions across settings. CipherHealth’s integrated engagement solutions help connect providers across the continuum, and in turn, reduce costs associated with complications and readmissions, improve quality of care, and enhance the care experience.
For more information on how we can help you to be a successful post-acute care collaborator under the CJR model, contact us today or download our overview.
In honor of National Patient Safety Awareness Week, we will be discussing various strategies that healthcare providers can deploy to improve patient safety. Keeping patients safe inside and outside of the hospital is no easy task, and it is critical that organizations look for programs and initiatives to promote this objective. Read on for strategies that hospitals can utilize to make lasting patient safety improvements.
1. Open Communication with Patients
Maintaining open communication with patients throughout the care experience is critical to ensuring that they are not at risk for an adverse event such as a fall, infection, or readmission. When patients share their medical histories, questions, and concerns, providers are more likely to identify an issue that could lead to a negative event.
From the time patients enter the hospital through their recoveries, care providers should be asking them questions about their needs and encouraging them to raise questions as well. Through processes such as rounding and post-discharge follow up, care providers can promptly address immediate issues, and uncover opportunities to improve communication moving forward.
2. Enhance Care Coordination
Care coordination means sharing information and bridging gaps between different departments, units, and providers in the care continuum. If a patient is transferred to a post-acute care facility, how will the new care provider receive the patient’s history? How might a social worker receive important patient information from a clinician? When your team has the tools to confidently answer these questions, you can deliver high-quality, coordinated care to keep patients safe.
3. Empower Staff and Build Trust
To ensure patient safety, front-line staff members must feel empowered to bring up issues, large or small, that may impact patient care. When staff members feel comfortable bringing up potential problems and are confident that those problems will be addressed, leaders can proactively prevent potential adverse events.
While creating a culture around communication can be difficult, leadership can start by taking small steps, asking staff members for their opinions and taking actions based on them. Processes such as staff rounding or employee surveys are great ways to collect this type of feedback.
With CipherHealth’s Evolve suite, care providers can easily understand and act upon patient issues. Thank you for joining us to learn more about patient safety. To join the campaign, be sure to check outwww.unitedforpatientsafety.org.
A new study from Northwell Health shows that most stroke patients are unsure of who their doctors are, and do not properly understand their medications. The study highlights the importance of ensuring patients understand their care plans to help reduce the risk of additional strokes. In the news release, researchers called for doctors to be more careful in informing the patients about their care plans and medications.
To minimize the risk of subsequent strokes and improve patient satisfaction, it is critical that stroke patients have a seamless care transition and are supported by their care teams. With the use of products like CipherOutreach and Echo, care teams can better proactively address patient issues before adverse events occur. To read more about the study, click here.