Transplant patients leave the hospital with more than just a new organ; they also depart with reams of information about medications, nutrition guidelines, lifestyle adjustments, hygiene, immunosuppression and exercise. To be effective the information must be tailored for individual medical needs, learning styles, languages and cultural preferences.
Effectively communicating hospital discharge information is particularly important for transplant patient populations who experience higher readmission rates than average due to the complexities involved. A study of national data spanning six years, conducted by the Johns Hopkins University School of Medicine, found that 30% of kidney transplant patients, who are typically healthier than other transplant recipients, were readmitted to acute care hospitals within 30 days.
The University of Wisconsin Hospital and Clinics, part of the UW Health system in Madison, Wisconsin, operates one of the country’s largest organ transplant programs. Consistently cited among the best in the U.S. for transplant patient outcomes, the hospital sought to further improve its discharge process to drive patient engagement and satisfaction.
As a first step in this effort, UW Hospital and Clinics incorporated the Vocera® Good to Go® solution into the discharge workflow for kidney transplant patients.
“Patients can become overwhelmed by everything that follows a transplant, so we’re always looking for ways to make it easier for them,” says Jessica Weber, Transplant Surgery Clinical Nurse Specialist at UW Hospital and Clinics. “It’s also challenging for clinicians to disseminate all the information required at discharge. Vocera Good to Go fits easily into the workflow of our nurses and other hospital staff, and it improves patient understanding and compliance with their post-hospitalization care plans.”
With the Vocera Good to Go solution, clinicians at UW Hospital and Clinics use an iPad® tablet to record personalized discharge instructions at the bedside, and can assemble a pre-recorded library of educational resources in audio, video and picture form. Patients, families and caregivers can access and review the information at any time, from most computers, tablets, and mobile devices. The patient-specific education and other clinically relevant material may include nutritional and exercise guidelines, medication instructions and possible side effects, infection prevention measures, timelines for follow-up lab work, and organ rejection signs.
Integrating Vocera Good to Go into our patient discharge protocol has proved very beneficial, and our staff has found it extremely easy to use,” says Elaine Snyder, Transplant Unit Nurse Manager at UW Hospital and Clinics.
Good to Go users at UW Hospital and Clinics include nurses, pharmacists, nutritionists, and transplant coordinators.
Care team members using Good to Go think in more detail about discharge instructions before recording them, and they are able to catch any errors or needed updates within the instructions before stepping into the room with the patient.
“Overall, the discharge process has become better organized because everyone is cognizant about whether or not something has already been recorded,” says Maria Brenny-Fitzpatrick, Director of Transitional Care at UW Hospital and Clinics. “As staff members become accustomed to using the Good to Go technology for their transplant patients, it’s improving the discharge process for their other patients as well.”
Usage among kidney transplant patients averaged approximately 33% within the first six months of deployment, which is double the typical usage rate for a new technology. Patients themselves are now more engaged in their education, and that information is also easily accessible by their supporting circle of care.
Vocera Good to Go exemplifies our commitment to driving patient engagement through innovation,” says Brenny-Fitzpatrick.
Patients say they use the system to check medication instructions and to reinforce discharge instructions: “It looks like a phenomenal program,” reports one patient. Another comments, “My wife and I reviewed [the information]; it reinforced everything.”
During implementation of Good to Go, UW Hospital and Clinics discovered a number of best practices that accelerated acceptance among the hospital staff and contributed to excellent patient usage numbers.
• Assemble key stakeholders to view and discuss the technology, and drive engagement throughout the planning process. Invoke collaboration among the clinical staff, nursing administration, transplant administration and technology staff. Enable a second unit-leader/champion for additional bench strength.
• Decide which discharge information to pre-record and make available in the pre-built library for efficiency and continuity of information, and what to record live at the patient’s bedside.
• As the initiative is planned and rolled out, ensure that everyone stays informed of progress and decisions made. Designate a representative for each discipline to attend meetings and disseminate information.
• Keep the meetings and lines of communication going, even after the solution is up and running, to enable an avenue for immediate answers to questions and concerns.
• Remain willing to conduct additional hands-on training for staff members unfamiliar or uncomfortable with the technology, so it becomes second nature to everyone.
While UW Hospital and Clinics began their use of Good to Go with kidney transplant patients, the solution is already in place for pancreas transplant patients and will also be rolled out for liver transplant patients.
Near-term future plans include expanding to populations such as plastic surgery patients that need significant education post-discharge on caring for wounds and tracheotomies, and radical prostatectomy patients who usually go home with a catheter and need to learn how to care for it. UW Hospital and Clinics is including a Spanish audio translation as well as Hmong, which doesn’t have a standard written language, to serve those populations.
“When patients are equipped with the information they need, they are more empowered in their health journey, which is ultimately what we strive for,” says Brenny-Fitzpatrick.
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