Tablet Technology Creating Educated Patients at Discharge.
The Connecticut Orthopaedic Institute in Meriden, Connecticut, was created in 2017 as a comprehensive orthopaedic unit with state-of-the-art equipment and exceptional amenities. The Institute is part of the Midstate Health Center, a 156-bed acute care hospital in the Hartford HealthCare system.
Stats to Know:
- Number of beds: 21 in primary pavilion, with 10 more available as needed
- Average number of joint replacements per month: Between 150–200
- Average length-of-stay for hip and knee replacement: 1.05 days
- Readmission rate: 1%
The Connecticut Orthopaedic Institute is emblematic of the next generation of orthopaedic institutes. With an intense focus on operational efficiency and best practices, the Institute combines superior care with patient-friendly amenities like valet parking, private rooms, a private kitchen, and advanced technology like an automatic texting system for families of patients. The result is a facility with high patient satisfaction, low readmissions, and low complications.
Patient education is vital at every step of the care continuum—including the use of The Wellness Network’s patient education and engagement solutions to help ensure that patients are prepared for a successful discharge.
“Thanks to patient education and optimization, and well-researched guidelines, we are able to get patients through the process safely and get them home quickly,” said Tom Mangano, operations manager. “We feel strongly that an educated patient and an educated coach will come to the hospital knowing what to expect, have far less anxiety about the procedure and their care, and they’re already mentally prepared that they’ll likely be going home the next day.”
Through its parent hospital, Midstate Medical Center, Connecticut Orthopaedic Institute uses a range of Wellness Network products to educate patients, including patient education tablets and access to COI.HealthClips.com, an online education platform that provides access to trustworthy education for in hospital/ clinic and at-home learning and an in-hospital broadcast channel. Highlights include:
- Online access to over 950 patient videos and resources through HealthClips, offering education on key topics including orthopedic care and management, mental health, ambulatory and palliative care, general wellness, infection prevention, medication management, preparing for discharge and at-home care and recovery.
- 51 tablets customized to delivery education specific to the orthopedic patient population needs.
The Patient Experience
While a successful discharge is an essential part of the center’s educational program, the effort to help patients understand their procedure begins long before they arrive on the day of surgery. This includes classes for new patients before surgery, a custom-created guidebook covering their procedure, and extensive staff support at every stage of their journey.
While the patients are moving through their procedure, the patient education tablets come into play outside of the operating room. During the procedure and recovery, the patient’s family is invited to wait in the Galleria, where they have access to tablets loaded with both patient education and entertainment like movies, games, and news sites.
“We offer the tablets on a complimentary basis,” Mangano said. “While the families are in the Galleria waiting, there’s also a coffee shop and a text-paging system that will give them alerts about the different parts of the process, including when it’s ending and when they can come talk to the surgeon.”
The tablets also have a feature custom designed for the unique mix of patients at the institute: built-in translation services in multiple languages, including Polish.
“Another added feature of the tablet is the ability to facilitate interpreter services directly at the bedside,” Mangano said. “Rather than staff trying to track down an interpreter telephone or other device, we now have quick and easy access to trained interpreter professionals.”
Total patient interactions, 2019: 18,000
Top viewed videos (includes tablet and online):
- “Discharge Video”
- “Understanding your discharge instruction”
- “Knee/Hip exercise video”
- “Joint Replacement : PT and OT Therapies”
- “Preventing Blood Clots”
45% of interactions were entertainment and spirituality
28% of interactions were focused on recovery, wellness and health education
Creating Successful Discharges
After the procedure—sometimes on the same day—the Connecticut Orthopaedic Institute turns to the tablets to help patients prepare for a successful transition home. According to a study authored by the Joint Commission, patient education is an important variable in a successful transition out of the clinic and thus plays a part in reducing readmission rates.
“One of the biggest things we’re using tablets for is a discharge video for patients in recovery,” Mangano said. “We created a custom 10-minute video that helps reset expectations and educates them about transitioning home.”
This video, which was loaded onto the patient engagement tablet with the help of The Wellness Network’s customer satisfaction team, is important because it frees up staff time while allowing patients to re-educate themselves and is specific to the process and protocols of the COI. Many patients emerge from surgery with questions—but they are often questions they’ve already received education on. The discharge video gives them an opportunity to digest this information at their own pace, without tying up a nurse navigator for 15 minutes (although patients do have the opportunity to ask follow-up questions as needed).
“The tablet is straightforward and user friendly. Our patients are normally in their sixties, seventies, or eighties, so they need an easy platform. The tablets are very well received by staff and patients alike. It’s very rare that we get feedback that a patient can’t figure out how to use the tablet, even if it’s their first time.”
— Tom Mangano, Operations Manager
In addition to the discharge video—which “virtually all” patients will watch before they are discharged—the patient education tablet is also pre-loaded with video content from The Wellness Network on joint replacement surgery and recovery, as well as custom education created by the Institute.
“The tablet feature I love in particular is that it gives patients the ability to email themselves copies of any content that’s written,” Mangano said, noting that the tablets have a special feature that allows patients to email themselves links to print and video education. “They can just hit a button on the top corner of the page, enter their email, and send it to themselves.”
Once patients get home, the education and follow-up continues with regular contact from nurse navigators and automated phone calls that may continue for up to a year after surgery, as well as continued access to the institute’s HealthClips website. This seamless education experience ensures that the education patients receive at home is consistent with the education they have access to at the Institute.
“We’re always about continuous reflection and improvement,” Mangano said. “Anything we can do to help readmissions and complications low, we’ll do that.”
1 The Joint Commission. “Transitions of Care: The need for collaboration across entire care continuum.” Hot Topics in Health Care, Issue #2 (2013). Available online at: https://www.jointcommission.org/assets/1/6/TOC_Hot_Topics.pdf