A telephone-based surgical transitional care program with improved patient satisfaction scores and fiscal neutrality

Abstract

Background: Limited data exist regarding the downstream effects of surgical transitional care programs. We explored the impact of such programs on patient satisfaction and fiscal metrics. Methods: A telephone-based surgical transitional care program enrolled patients undergoing complex abdominal surgery between 2015 to 2017. A matched cohort undergoing similar procedures between 2010 to 2015 were used as controls. Press Ganey scores were used to reflect patient satisfaction. Hospital costs, reimbursements, and margins were analyzed for index hospitalizations and readmissions within 90 days of surgery. Results: There were 607 patients in the control group and 608 in the transitional care program; survey response rates were 37% and 35%, respectively. Transitional care patients rated their understanding of personal responsibilities in post-discharge care higher than controls (59% vs 69%, P ¼ .02). Transitional care patients felt they received better educational materials about their condition or treatment (55% vs 68%, P < .01) and rated their global hospital experience higher (46% vs 57%, P ¼ .02). The aggregate (index plus readmission) cost was greater for the transitional care

Systematic review of contemporary improvement interventions on care coordination, discharge support and transitional care from the patient experience perspective

“…Among the 1087 unique papers screened, 138 full texts were assessed for eligibility and 15 were included. 15 16 26–38 The absence of impact assessment with inferential statistics was the main reason for exclusion at the full-text assessment. Among papers included, seven focused on enhanced care coordination supports (e.g., over and beyond models of care based on a PCMH), whereas eight focused on enhanced discharge supports, specifically for enhanced patient education, reengineered discharge, telephone follow-up including for transitional care, or a mix of those interventions.…”

“…31 Both achieved improvements in selected patient experience items (e.g., information provision). In turn, an observational study with historical controls focused on a telephone follow-up after hospital discharge with possible remediation plans or rescue resources (e.g., same-day clinic appointment); 15 it achieved higher percentages of top-box scores (i.e., highest score on the given patient experience items) compared to controls for 5 of the 11 patient experience items. Several risks of bias applied to the three studies (Table 3), including risks of contamination and unadjusted analyses.…”

“…12 13 Overall, healthcare systems, organizations, and frontline practitioners are increasingly subject to quality mandates, value-based incentives, or market pressures (e.g., customer loyalty) to develop systematic activities to improve their patient experience performance, 14 including for care coordination and discharge support. 15 16…”

The effectiveness of a mHealth-based integrated hospital-community-home program for people with type 2 diabetes in transitional care: a protocol for a multicenter pragmatic randomized controlled trial

“…Transitional care models are diverse in their health resources and local cultural characteristics [5]; they can be offered by teams or individuals [16,17], include home visits or telephone coaching [18,19], and be provided by the community or the hospital [20,21]. The different forms have shown mixed results in terms of disease outcomes.…”

Systematic review of contemporary interventions for improving discharge support and transitions of care from the patient experience perspective

“…Several other countries require providers to monitor and improve patient experience [ 12 , 13 ]. Overall, healthcare systems, organizations, and frontline practitioners are subject to quality mandates, value-based incentives, or market pressures (e.g., customer loyalty) to develop systematic activities to improve their patient experience performance [ 14 ], including for care coordination and discharge support [ 15 , 16 ].…”