Healthcare Case Study  

CASE STUDY: Healthcare SafetyZone® and Discharge Callbacks for Cone Health

Client: Cone Health is a not-for-profit network of healthcare providers serving a number of counties in north-central North Carolina. As one of the region’s largest and most comprehensive health networks, Cone Health comprises more than 11,000 employees, 1,300 physicians and 1,200 volunteers across more than 100 locations, including six hospitals, three ambulatory care centers, three outpatient surgery centers, four urgent care centers, a retirement community, more than 75 physician practice sites, and multiple centers of excellence. Cone Health has grown tremendously in the last few years, including the establishment of an Accountable Care Organization in 2010.

TOTAL REPORTING MODULES   9

TOTAL EVENTS SUBMITTED  250,000+

Climate: Cone Health made the transition from paper-based to electronic event reporting back in 2003 when it implemented Clarity’s Healthcare SafetyZone® system. Like many of our clients, Cone Health’s adoption and use of the SafetyZone system was initially born out of a need for an electronic incident-event reporting solution. Due to the flexibility of the Healthcare SafetyZone®, the system evolved to include other report-review, data-driven processes.

Cone Health is immersed in the prominent changes in the healthcare landscape brought on by healthcare reform and the Affordable Care Act. Central to the Cone Health approach is a deep concern that the culture of its organization must make the patient truly the center of its activities. As part of this awareness, the organization decided to take a proactive approach to managing its patients’ experiences, and focused its attention and resources on patient engagement, satisfaction, and ultimately, retention.

Changes:

The Office of Patient Experience - Cone Health created its Office of Patient Experience (“OPE”) in 2011, partially because of the aforementioned structural shifts that were happening in the industry, but more so as a result of internal cultural changes that had led to an increased focus on proactive patient safety management concepts. By design, Cone Health’s Office of Patient Experience is chiefly dedicated to helping its leaders and caregivers provide optimal experiences for patients all across the organization.

Discharge Callbacks - Along the way, a number of factors led to a determination among OPE staff to dedicate resources to performing discharge callbacks on a growing number of patients. Until that point, discharge callbacks happened as needed, based on individual circumstances. Now, discharge callbacks would happen as a matter of course, as a centralized process within the Office of Patient Experience.

ADVANTAGES OF PERFORMING REGULAR DISCHARGE CALLBACKS
- More in-depth feedback from patients when their experience is fresh
- Potential to reduce readmissions due to quick intervention
- Patients are more likely to offer positive HCAHPS responses based
simply on whether or not they received a call after discharge

“We weren’t looking for a product, we were looking for a solution to a problem. Clarity’s Healthcare SafetyZone® is a solution to a problem—to many problems, actually.” - Director of Patient Engagement, Cone Health

The SafetyZone Solution: Now that Cone Health had decided to create a formal Discharge Callback Program, the next question was, how to execute it? How to do so efficiently, intelligently, and with minimum overhead? How to facilitate the calls themselves, and how to capture the results of the calls in a way that ensures any data gathered will be meaningful and easily translatable into action?

The decision was made initially to use Nursing staff to make the calls in the Discharge Callback Program. Nurses are trained to “be the voice of the patient” in making and documenting the calls, and patients find comfort in talking to nurses over more administrative personnel. Nursing staff were also already quite proficient at using the Healthcare SafetyZone® for a number of data collection and management needs, including its incident reporting tool.

Sensing an opportunity to capitalize on the flexibility of the SafetyZone system, the Office of Patient Experience immediately set out to develop a custom electronic discharge callback form and an accompanying process using the SafetyZone’s existing reporting-workflow-review capabilities. The SafetyZone is very user friendly and it only takes a few minutes to fill out the custom forms. The process is conducive to making phone calls, which allows nursing staff to fill out the form in real-time while they are on the phone.

The built-in notification system, and the review and analysis capabilities of the SafetyZone, combined with the ease of use, helped assure the administrators in Cone Health’s OPE that it was the right tool for the job.

Results: Patients Experience High Touch - Currently, the Discharge Callback team calls nearly 100% of inpatients discharged to their home through the system. They make two phone attempts and reach approximately 60-70% of patients. They perform calls for all emergency departments as well, at a rate of 60-70%. Overall, based on Cone Health’s own surveys, 50-60% of respondents indicate that they have received a call.

In only a few cases, the Discharge Callback team has learned that a patient has a negative demeanor or is specifically in need of something. In those situations, the electronic callback report can be flagged for immediate follow-up with auto notifications sent to the appropriate operational leader(s) who can then contact the patient directly to mitigate the problem.

In most cases though, which are more routine and do not need immediate intervention, discharge callback reports are generated automatically through the SafetyZone on a weekly basis. With a simple export from the SafetyZone, the entire team and all relevant parties receive information from each campus, including number of calls, number of complaints/compliments, patient call reach rate, necessary interventions, and much more.

The Discharge Callback Program has allowed Cone Health Staff to touch base with the patient after he or she leaves the hospital and better understand the patient’s transition from the hospital to home. This has enabled Cone Health to determine if at home resources are adequate, and many times, it has led to the patient receiving other necessary services to keep him or her on the right therapeutic path.

“We were very clear from the beginning how we wanted to structure the calls. We didn’t want to sacrifice the integrity of the process in order to make it work with the system. The SafetyZone system is built around us, rather than us having to modify our process to work with it.” - Director of Patient Engagement, Cone Health

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