Beyond bringing the patient in as the captain of the team, it's also necessary, in some cases, to hand off care responsibilities directly to patients. For example, in a four-year study published in the Harvard Business Review, a group of 1,000+ patients who self-administered IV antibiotics at home had a 47 percent lower 30-day hospital readmission rate than those getting treatments at an outpatient facility.
Easy-to-learn, high-value tasks like this, as well as pain management, physical therapy, wound care and enteral nutrition (tube feeding), can be ideal targets for self-care.
Of course, patients must be taught these skills. Showing patients how to dress their own wounds is often a requirement for hospital discharge, and a quick way to reduce costs for both patients and health systems. Using “teach-back" sessions, wound care specialty nurses act as coaches to demonstrate and walk through the patient’s dressing care, while describing symptoms of infection. Patients then repeat the process while asking questions along the way, which reinforces ongoing communication with their healthcare team, said Maria Kotula, clinical operations manager, Wound Management at Cardinal Health.
Kotula also sees value in including family members or loved ones in wound care training, involving them more directly in the patient's team. “It's really an amazing turning point to see the impact on patient healing when they realize they don't have to face the battle alone," said Kotula.
Enteral nutrition, where nutrition is delivered via a feeding tube into the gut, may also be a requirement for hospital discharge when patients can't take food in by mouth after a procedure, injury or disease. And just as critically, medical insurance won't typically cover the costs of home enteral nutrition delivery by nursing staff, so from a healthcare cost perspective, it's important to give patients those skills.
“Patients go home on enteral nutrition because they no longer require acute inpatient care for their clinical condition," said William Nadeau, medical affairs manager for Cardinal Health. “But enteral nutrition can present difficulties because of its complexity, and patients can experience re-admittance due to enteral feeding related complications."
Technology is also allowing clinicians to monitor pump operations remotely to greatly reduce clogging or mistakes in administration.
“Patients can be better served by not only having devices they need, but also the education on how to use them and the ability to communicate with their clinicians remotely," said Nadeau.