Technology Automation Drives 7% Reduction in Hospital Readmissions
With the use of technology automation and AI in healthcare, dedicating time to the people and processes impacted is critical. Learn how Freed helped a multi-facility health system greatly reduce hospital readmissions through technology automation and by helping the people impacted through the change
Post-Discharge Support Reduces Hospital Readmissions
Effective hospital discharge follow-up is a key part of care coordination. It’s an essential practice that helps patients stay healthy after they leave the hospital while avoiding costly, stressful readmissions.
To be effective, discharge follow-up support resources must be deployed thoughtfully. And to ensure the most effective use of resources, the support should be carefully tailored to each patient’s unique needs.
Focusing on People and Compassionate Change Management in a Technology and AI-enabled World
Freed Associates engaged with a multi-facility health system that offered multiple post-discharge support programs to meet a range of patient needs. One of these programs provided virtual care navigation for 30 days after hospital discharge. To determine which patients were at high risk for hospital readmission and should be a part of the program, an algorithm was used. The algorithm considered clinical factors and social determinants of health such as homelessness and food insecurity.
The issue at hand was that high-risk patients identified by the algorithm could not be enrolled into virtual care navigation automatically. Instead, a manual outreach and enrollment process was being used. This required internal teams to spend days making outreach calls to inform patients about the program and encourage registration.
To increase efficiency, an automated phone outreach system using a phone tree and text messaging was implemented. This did solve a portion of costly, time-consuming tasks; however, the healthcare team was unprepared for the change in process. Without proper training and change management, the team filled its time with new manual tasks, including inappropriately enrolling patients who “might” fit the program.
Freed Managed the Implementation of a New Algorithm and Randomized Control Trial (RCT) to Drive Transformation
The Freed team managed collaboration between the health system’s technical, operational, and research teams to create a revised algorithm that improved the identification of patients who will benefit from virtual care coordination. Obtaining alignment on the right patient criteria was essential for increasing the effectiveness of the algorithm.
To accurately assess the efficacy of the new algorithm and the entire virtual care coordination program, a Randomized Control Trial (RCT) was set up. The RCT randomly assigned qualified patients to the program or to a control group. This allowed the health system to accurately measure effectiveness and determine if the program should be expanded to include additional patient populations.
The Freed team provided vital change management support to ensure adherence. For instance, some staff members struggled with the notion that only half of the RCT patients received immediate services. Freed offered ongoing support to address questions, concerns, and process enhancements.
Proven Results: Reduced Readmissions and Increased Patient Satisfaction
The team conducted statistical analysis of trial results revealing a 44% increase in patients referred to the program and a 7% reduction in readmissions among those receiving targeted transitional care support at discharge. Insights from the analysis helped identify patient populations benefiting most from the program and the increased enrollment led to higher patient satisfaction.
After 7 months of data collection, the study concluded. The control group, previously not receiving post-discharge support services, was integrated into the program. And Freed provided ongoing support to ensure the team was informed, engaged, and equipped to manage the influx of new patients.
Freed’s collaborative approach to change fostered innovation that drove tangible outcomes, including cost savings, heightened employee efficiency, and greater patient satisfaction.
