Theresa Pinn-Kirkland, Houston Methodist: Anecdotally, we all know if you do a good job with post-discharge transitioning care, if you’re helping patients to transition home safely and closing these gaps, that you end up with patients who are happier, who have better health outcomes, who don’t come back to the hospital for unnecessary readmissions or revisits…But it’s hard to quantify that.
And so, we were finally able to, with this study, compare cohorts, and we looked at engaged patients – so anybody who had three or more incoming text messages with us – because our first one is, “Do we have the best number for you?” Next day, “Do you have any questions?” …That’s not really a meaningful engagement. “I’m glad you participated,” but I don’t want to count that as somebody that we helped or that we had a conversation with.
So we looked at three or more incoming. We found that patients were happier, which we knew just from the text conversations where they said, “Oh my God, thank you so much. Like I just was really worried ‘is this normal? I’m still so tired.’ You were just in the hospital for a week, you’re going to be tired for a while. “Is this normal?” is the question we get billions of times every day.
So happier patients, great, but that doesn’t really help with buy-in a lot of times because you kind of have to “show me the money thing.” And so, we were able to show that we had fewer readmissions, and comparing the cohorts, they were very similar as far as demographics. And the group that didn’t come back actually were higher on the case mix index. So these were patients that were more sick that we were keeping from coming back if they didn’t need to.
And with revisits, if you can direct them, well, this is something you can address with your PCP. This is something you can wait and call the surgeon’s office. This, you need to go see an urgent care. No, you definitely need to come back to the ER right now for that.
If you address it sooner, that means it can get treated, patients can go home and not wait to where they have to get readmitted because now they’re in worse states.
So it was great to be able to have some statistically significant data. For the HCAHPS, we have seven hospitals, and so there was as much as a 7.4 difference in individual domains at individual hospitals. Looking overall at the system, there was a 2.8% increase in their rating for overall rating of the hospitals. So it’s definitely been something that has now gotten leadership’s attention.
