Andrew Hresko, Cardiovascular Roundtable
CV leaders know that post-discharge self-management plans are crucial to avoiding readmissions. For more than a decade, studies have shown that discharge planning can reduce readmission risk for heart failure (HF) patients. But these plans are only effective when patients are willing and able to comply.
To make sure patients can adhere to these directions, programs must provide thorough education on self-management skills. However, education often becomes a “cram session” that occurs shortly before discharge, when patients and family are anxious and less able to process complex instructions.
Fortunately, you don’t need to revamp your entire discharge planning approach to make instructions stick. CV leaders at South Nassau Communities Hospital in Oceanside, N.Y., supplement traditional one-on-one bedside delivery with group HF education sessions.
South Nassau reinforces the message in non-clinical setting
South Nassau’s initiative started when its HF leaders realized that traditional discharge education delivery was often inadequate; busy clinicians were forced to rush through discharge instructions while patients were still in the inpatient unit.
They developed a group discharge education program that removes these barriers. The voluntary, one-hour session for patients and their family members is held right after discharge in a comfortable, non-clinical room. During the meeting, a multidisciplinary team including a CV nurse, a dietitian, and home care staff reinforces important self-management strategies to a group of about four patients and families.
Group format has patient and provider benefits
The group format is critical to the sessions’ success. Participating HF patients have said they feel comforted by meeting others facing the same challenges and forming a support network, and participating nurses are able to optimize their time by teaching self-management skills to four patients at once.
As the graphics above show, patients are highly satisfied with the sessions, rating them at 4.6 on a 5-point scale, on average. South Nassau has also seen a drastic reduction in readmissions as a result of the program. Group discharge session participants have an average 90-day readmission rate of 18%, while HF patients receiving standard care have a 32% readmission rate. These successes indicate that group discharge education could be another effective tactic for any HF program looking to improve patient self-management and readmission rates.
If you’re interested in learning more about South Nassau’s approach, they’ve published detailed findings on the group discharge education sessions in Clinical Nurse Specialist.
Another Way to Make Discharge Instructions Stick: The Teach-Back Approach
Many programs use the “teach-back” approach to post-discharge education, in which patients are instructed to repeat instructions in their own words to reinforce their comprehension and confirm their understanding of the care plan.
We've pulled together the latest resources from our library and beyond to help you master this approach. See the resources.
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