Improved patient compliance reduces readmissions

As healthcare reform focuses on holding providers accountable for patient outcomes, how do providers engage their patients to adopt better self-care behaviors?

In terms of patient involvement, most research has revealed low participation regarding compliance to a prescribed self-care regimen, this includes:

•    Non-compliance with medication: Numerous studies have shown that patients with chronic conditions adhere only to 50-60 percent of medications as prescribed.
•    Dismal follow-up: About 20 percent of patients don't follow up on their doctor's referrals to specialists.
•    Non-adherence to changes in lifestyle: Exercise regimens are not followed by 41–58 percent of heart failure patients. Compliance with a sodium-restricted diet varies from 50 percent to 88 percent in heart failure patients.

Lack of compliance with medications, delays in seeking medical attention, and failure to follow a recommended exercise and diet regime are among the primary reasons for the high rate of re-hospitalization among patients with chronic conditions.

Providers considering joining an ACO and serving a specific patient population will need to consider a strategy for improving patient participation if they want to maximize their ROI.

The following are some tactics that can get patients more involved in improving their own outcomes.

1.    Start Early – Most research indicates that the motivation to change one’s lifestyle is the strongest within 1 to 2 days after a surgical procedure. After 2 to 4 weeks, motivations will decline and patients who do not feel pain (after successful surgery) may not be as motivated to change behaviors. This is because patients may incorrectly view the surgical procedure as a cure rather than a treatment for a chronic disease.
2.    Ask Questions  – Caregivers have better success when they couple questions with reminders when they follow up with their patients. For example, instead of staff just calling staff to remind their patients to do their exercises, they should also be asking the patients what specific exercises the patient is responsible for performing.
3.    Educate with an Interdisplinary Team - One study compared the readmission rates of patients that received education from a nurse educator, dietary and physical therapy consultations, routine telephone contact after discharge, and home visits from nurses trained in management of heart failure with those that had only “usual care”. The results of the study indicated that hospital readmission rates were 4 times higher in the group of patients that did not have the interdisciplinary education support. Additionally, the patients that did not receive the interdisciplinary support required nearly 50 percent more skilled nursing care visits and more than twice as many home health aid visits. The study estimated a 6-week cost savings of $67 804 for the group received the interdisciplinary education.

Self-care tactics such as these, along with technological and infrastructure policies, should be considered as part of a comprehensive strategy to maximize patient outcomes and ROI for a patient population.

Ryan Sparks is general manager & VP of enterprise sales at Care2Learn.