Building Strong Patient Transition Programs: How Does Yours Rate?

Neil Gulsvig is the CEO of Align, and has more than 35 years of experience in the senior healthcare industry. He has an extensive knowledge in human resources, communications, and operations. 

It’s no secret that providers are feeling more and more pressure to make sure that patients have safe and sustainable transitions back to the community following a short skilled nursing facility stay. Bundled payments, ACOs, readmission penalties, and increased regulatory scrutiny are your new reality if your business strategy includes post-acute short stay services.

So, how does your organization rate? And are there areas for improvement?

Using the seven key drivers of successful patient transitions listed below, ask yourself these questions to help determine where you shine or where improvements are needed:

1. Do you engage patients actively and early in their stay?
Research shows patients who are actively engaged throughout their post-acute stay are more likely to be successful managing health care needs once discharged.

2. Do you identify patient expectation gaps?
When do most post-transition failures happen? Unrealistic patient and family expectations, that are not adequately addressed during the stay, can be a culprit.

3. Do you ask the right questions at the right time?
Have an impact on the perceptions and experiences of your patients while they’re still with you. Asking the right questions while patients are still in your care makes it possible to address service failures and to identify transition readiness gaps that must be addressed before the patient is discharged.

4. Is timely, relevant patient education provided?
Patient education has been found to directly correlate with successful post-transition outcomes. Are you providing education that is timely, relevant to the patient’s needs, and designed to sustain post-transition success?

5. Do you measure patient readiness to self-manage?
Confident patients (and their families) at the time of transition are much more likely to self-manage successfully. Make sure you know whether a patient is prepared to make that transition.

6. Do you provide clear post-transition instructions?
This seems like a no-brainer, but many organizations provide patients with hard-to-understand instructions for post-discharge care. Provide clear, easily understood instructions to best-position patients for success.

7. Do you follow-up with discharged patients?
Positive post-transition outcomes are a necessity. Discharge can no longer mean good-bye and good luck. It’s a critical business priority to know how your patients are doing after their transition from your care.

Engaged patients will have a better experience overall during their stay with you and they’ll also be better prepared for successful post-transition outcomes when these key contributors to success are well-managed. By asking yourself these questions, and evaluating your current processes, you’ll be on your way to engaged patients, successful transitions, and improved relationships with your key market stakeholders.

Now that you know how to engage your patients, it’s important to understand how to engage your employees.

Follow the link to learn more about Align.