The First 24 Hours

The first 24-hours when a patient and family start hospice service is key to the patient experience and also related to the rate of revocations. The best way to grow your census is not to lose any business you already have. Providing the most outstanding service and care within the first 24-hours is a key strategy for growth.

I was on a conference call today with a group of hospice executives discussing this exact subject. There was a common theme with this dialogue that showed that there was not a consistency in the approach. Families and patients are scared just because hospice is hospice. Further, the fear of the unknown on how hospice works adds to the anxiety. All this is compounded if the patient is coming home from the hospital.

Patient satisfaction surveys showed that the first 24-hours are critical. When I was President of Hospice Care of the West, we embraced a strategy to enhance the patient experience and came up with these actions.

  1. The admissions nurse had a checklist to things the family could expect would happen during the first 24-hours. Such things as; how medications will arrive, a visit from the Nurse Case Manager, etc.
  2. The Patient Care Manager called the family to introduce him/herself and talk about the care team who would be taking care of them and answer any questions.
  3. The after-hours service was described in detail and we made sure the family/patient knew the number.
  4. We told the family/patient we would be calling the patient’s primary care physician to provide a status report.
  5. The purpose of the Emergency Care pack was reviewed and a location of the packet in the home was assigned.
  6. A tuck-in call was made to the family to check in and see how things were going. This would happen sometime between the 24th to 48th hour.

Several people on the conference call looked at the following metrics to measure the impact of an enhanced first 24-hour strategy.

  • The Cost Per Day for the first 24-hours. To determine if the start of care cost were less when a “first 24-hour” strategy was in place.
  • Patient Satisfaction. Several questions were included to measure satisfaction during the first 24-hours.
  • Revocation. While a broader measure, declines in revocations were measured.

The byproduct of the first 24-hour strategy was that it helped in the creation of a “Culture for Growth” which I have written about in past post.
So what are your thoughts on a focus during the first 24-hours of hospice service? Does it contribute to a better patient/family experience?

The Best!

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