Improving Outcomes through Patient Engagement: 3 Key Strategies

By Sean R. Muldoon, MD, MPH, FCCP, Chief Medical Officer, Kindred Hospitals


Compounded by the pandemic and driven by increased consumerism, patients are more interested in their healthcare choices than ever before. Providers must remain educated and focused on patient engagement preferences.

Increased transparency during care, the use of technology, and post-discharge communication are all growing in demand. Patient-centered practices are resulting in improved outcomes as they evolve to meet consumer expectations.

This article outlines research on the connection between patient engagement and improved outcomes, as well as three key strategies providers are implementing to deliver on these outcomes.

How patient engagement and satisfaction improve outcomes

Trending: Consumer interest in health

In the years leading up to and throughout the COVID-19 pandemic, consumers have taken a greater interest in their overall health, especially those with chronic illnesses. In a 2020 survey conducted by The Advisory Board, 66% of respondents with chronic conditions were more interested in taking a proactive approach to health, and 56% were more interested in managing their underlying conditions than prior to the pandemic.1

In a 2020 survey conducted by The Advisory Board, 66% of respondents with chronic conditions were more interested in taking a proactive approach to health, and 56% were more interested in managing their underlying conditions than prior to the pandemic.

Effects of consumer involvement on patient outcomes

With consumers’ growing interest in their care, physicians are increasingly seeing the benefits of greater involvement with regard to patient satisfaction and outcomes.

Recent studies support this connection with the following conclusions:

  • Patients with a lower Patient Activation Measure (PAM), which measures patient involvement, are more likely to experience “major medication errors, emergency department visits, and/or unplanned readmission”.2
  • Inpatients who rate their care with a lower degree of satisfaction are more likely to readmit within 30 days with post-discharge complications.3

Greater patient involvement and satisfaction, therefore, are key contributors to patient outcomes.

Benefits of patient engagement to providers

Research also reveals that patient involvement lowers total cost of care:  

  • Patients with the lowest engagement rates showed total costs of care that were 8% higher in the first year and 21% higher in the next year than those of patients with high engagement scores.4
  • Patient satisfaction is linked to greater market share, fewer malpractice claims and higher reimbursement rates.5

These studies, among others, reveal the benefits to patients and providers of increasing engagement and satisfaction and therefore providers should explore and consider implementing engagement practices.

3 Key Patient Engagement Strategies  

Patient inclusion in interdisciplinary care team discussions

One innovative approach to improving patient satisfaction and outcomes is to establish protocols for including the patient in typical care team discussions. Interdisciplinary care teams bring together physicians, therapists, nurses and other caregivers in a coordinated approach to the patient’s treatment. This improves the efficiency and quality of care and minimizes the risk of miscommunication between all parties. This is essential, as communication failure is one of the most common causes of patient setback and delayed discharge.6

When providers establish rigorous practices for patients to participate in these conversations, coordinated care becomes even more effective. Patients involved in care decisions have:

  • More realistic expectations of side effects or recovery time
  • Less anxiety about their treatment
  • Greater adherence to their treatment plans

These benefits all contribute to greater patient satisfaction and improved outcomes.7

Technologies that connect and inform

Technologies that can help patients, families, and caregivers communicate and track progress are also contributing to effective patient-centeredness. Mobile apps that allow patients and caregivers to set and track goals or access care notes can help patients visualize the next step in their recovery. 

Studies have shown that:

  • Informed, engaged patients are likely to be more confident regarding their care and rehabilitation and more likely to be satisfied with their overall experience and outcomes.8
  • Patient engagement is associated with improved self-care and recovery.9,10
  • Strong patient and family engagement in clinical care positively contributes to a favorable experience, as well as improved health outcomes and reduced costs.11

With 11% of family members living more than an hour’s distance from the patient, and with a recent pandemic that prevented even local family members from visiting in person, technologies that can bridge geographical gaps are critical to patient satisfaction and recovery.12

Post-discharge follow-up

While the aforementioned approaches are designed for patients in a hospital setting, patient-centeredness does not end with discharge. Research on the subject reveals that:

  • Patients that were hospitalized with acute conditions are less likely to readmit if they are contacted as part of an early follow-up program post-discharge.13
  • In patients with three or more chronic conditions, 20% of readmissions are likely to be prevented if they are contacted by a provider of care within 14 days of discharge.14

In patients with three or more chronic conditions, 20% of
readmissions are likely to be prevented if they are contacted by a provider of care within 14 days of discharge.

  • Based on consumer survey results, there is no significant difference in satisfaction between nurse-led telephone follow-ups and outpatient visit follow-ups, suggesting that telephonic programs are effective patient engagement tools.15,16

Implementing post-discharge follow-up services not only improves patient satisfaction but can also reduce total cost of care over time as rehospitalizations or other major setbacks are prevented.

How Kindred Hospitals are applying patient engagement strategies

Interdisciplinary Care Teams

Kindred Hospitals feature interdisciplinary care teams of physicians, nurses, dietitians, skin specialists and rehabilitation therapists who collaborate to coordinate patient-specific care plans. As part of their advanced care delivery model, Kindred’s interdisciplinary care teams go above and beyond by conducting their daily meetings at the bedside of the patient whose care plans they are discussing. Previously, such meetings were conducted in a conference room away from the patient and family. Kindred, however, recognized the immense benefit of transparency during the care plan creation and progress, as well as patient and family inclusion, and therefore moved these meetings to the bedside.

RehabTracker

Kindred Hospitals specialize in the treatment of patients who require intensive care and rehabilitation in an acute hospital setting. With RehabTracker®, a new proprietary patient engagement mobile and web-based app, they are transforming the way caregivers engage with patients and their families. The HIPAA-compliant RehabTracker app ensures that the patient, clinical team and family both near and far are informed on progress and can recognize recovery milestones. RehabTracker is built with unique functionality to serve patients of all levels of conditions, including the needs of medically complex and critically ill patients.

RehabTracker

Restorative Tracking

One key component in rehabilitation is mobility, the most common measure of which is walking distance. However, mobility in an LTACH setting includes movements such as rolling to one side of the bed or sitting up. For critically ill patients, clinicians use RehabTracker during sessions to monitor progress in areas such as range of motion exercises and time spent sitting at the edge of the bed. While these are seemingly minimal actions, our clinicians explain these critical accomplishments to patients during sessions using visuals in RehabTracker, which are also available to friends and family so they can follow along regardless of their location or time of day. Patients in restorative therapy have a particular need for this encouragement and motivation which can contribute to speed of their recovery.

Respiratory Therapy

Clinicians can also use Kindred’s RehabTracker to connect patients and families on respiratory therapy, which can be one of the more intimidating aspects of rehabilitation. Respiratory failure and respiratory conditions requiring ventilator support are among the top DRGs of patients admitted to LTACHs.17 Kindred Hospitals, with disease-specific certifications in Respiratory Failure from The Joint Commission, and with their Move Early Mobility Program, specialize in treating and rehabilitating these patients, especially those needing ventilator liberation. Patient progress in unassisted breathing and oxygen intake and saturation are important aspects of respiratory therapy that can be monitored by clinicians in the RehabTracker app. With so many patients admitting to LTACHs with pulmonary conditions, Kindred’s app ensures that patients and families can connect on this critical component of their recovery.

AfterCare

The Kindred AfterCare program is designed to help recovering patients heal and to provide the support they need once they have discharged to home from our hospitals. Specialty trained RNs will review patients’ charts and reach out to patients within 12-48 hours, 7 days, 14 days, and 30 days post-discharge. They discuss durable medical equipment and medication needs and education, primary care provider appointments, continued progress and any additional post-discharge services needed. This program improves patient outcomes and satisfaction as well as reduces the rate of readmission.

If you have a post-COVID or other patient in need of continued acute care, call a Kindred Clinical Liaison for a patient assessment. Our experts will help you determine whether an LTACH stay is appropriate for your patient. If you are unsure of who your Kindred representative is, please feel free to contact us via recoveratkindred.com and speak with a Registered Nurse who can assist.


References

  1. Advisory Board Covid-19 Consumer Survey, June 2020. https://advisory-prod.azureedge.net/-/media/project/advisoryboard/shared/research/mic/resources/2020/
    impact-of-covid-on-site-of-care-and-comms_consumer-survey-results.pdf?rev=471d77d6ebf4426e8b7bb179235aa253&hash=F7675411F86C8D98E35333B14584BB82
  2. https://www.sciencedirect.com/science/article/abs/pii/S0002914917312109
  3. https://qualitysafety.bmj.com/content/27/1/48.abstract
  4. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2012.1064
  5. https://journals.lww.com/jbjsjournal/Abstract/2013/05150/Patient_Satisfaction
    __Implications_and_Predictors.20.aspx
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526935/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996004/
  8. https://pubmed.ncbi.nlm.nih.gov/30403575/
  9. https://pubmed.ncbi.nlm.nih.gov/17610432/
  10. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157149
  11. https://link.springer.com/article/10.1007/s40746-016-0072-6
  12. https://doi.org/10.26419/ppi.00103.001
  13. https://pubmed.ncbi.nlm.nih.gov/20442387/
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369604/
  15. https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-10-174
  16. https://www.sciencedirect.com/science/article/abs/pii/S1462388910000840
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369604/

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