Recently, Charleston Area Medical Center(CAMC) a non-profit, four-hospital system in West Virginia, completed a two-year study looking at reducing readmissions for chronic obstructive pulmonary disease (COPD) and other chronic conditions. Prior to the study CAMC already had many key measures in place.
There were two main touch points:
- On admission, a detailed clinical assessment identifying the patients with the most severe conditions.
- On discharge a completed education plan to ensure the patient had the most important information to establish effective care upon leaving the hospital. Healthcare providers engaged in the education plan had a variety of tools to help patients.***
In the initiative, CAMC added standardized patient education to increase patient engagement. The standard took the form of an information prescription with patient education videos at the core of the prescription. Patients and the nursing staff understood that these prescriptions for education were mandatory.
The prescription involved three main components:
- Patient education videos (five videos from Milner-Fenwick, which is a division of The Wellness Network, were used).
- Quizzes/Assessments were developed to follow the videos to assess comprehension and support teach back.
- Written support resources (written at a 6th grade reading level).
Using this methodology, CAMC documented lower readmission rates for both diseases. Over a two-year period, they saw readmission rates for COPD and Pneumonia drop by 29%.
Improved measurements of readmissions and HCAHPS scores can be linked directly to their timing and usage of educational efforts. CAMC has seen that even with lower literacy rates, videos can help communicate these key messages. While there may always be a need for print-related patient education, CAMC outcomes study encouraged increasing the use of videos for patient engagement and reducing readmissions. They are already expanding video information prescriptions to Heart Failure.
A goal of CAMC is to provide education and engagement across the care continuum. To expand usage across all points of care, use of the videos outside the hospital via web usage will be added in the near future.
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Tools engaged to help patients:
- Referrals to Pulmonary Rehab, Cardiac Rehab, and psychological support as appropriate.
- A 30-day supply of prescription medications and counseling by CAMC pharmacist.
- Escalation to a skilled nursing facility for patients who are too sick to be discharged to home.
- Scheduling a follow up appointment with the patient’s primary care physician within 7 days of discharge.
- Making a home health services referrals where appropriate.