After Visit Summary Redesign by

After Visit Summary Case Study

jmeyers44 — 2024-02-02 00:00:08 UTC

After Visit Summaries Improve Communication

jmeyers44 — 2024-02-02 00:12:21 UTC

After Visit Summary Guide

jmeyers44 — 2024-02-02 00:14:44 UTC

Go Live Checklist

2024-02-02 22:24:17 UTC

After Visit Summary

2024-02-02 22:25:24 UTC

Process

2024-02-02 22:30:15 UTC

This taskforce will be responsible for optimizing the after-visit summary, so that patients will have clear and concise directions on their AVS.

Objectives

2024-02-02 22:32:47 UTC

The objective of the AVS taskforce is to identify areas for modification and make improvement, so that the AVS can be 75% error free for patients on discharge.

Process Scope

2024-02-02 22:33:17 UTC

The scope of the AVS taskforce will be to promote open dialogue of the after visit summary so as to effectively enhance the AVS. The following steps will be considered for this project: 1. Conduct a current state assessment of the discharge after-visit-summary. 2. Identify gaps and potential opportunities for improvement of the AVS 3. Determine best practices and evidence based practices to standardize the processes for an improved after visit summary for patients 4. Implement standards and best practices to eliminate harm and improve quality of care.

Managing the "Go-Live"

2024-02-02 22:36:57 UTC

“Go-live” checklist will consist of making sure the process has been reviewed and tested, the project has been signed off and is ready to be deployed, email communication has been sent out to end users notifying them of “go-live” date, end users have been trained successfully and have access to the necessary features, and making sure the readiness assessments have been completed (OCM Solution, 2024).
Core implementation team available during hospital discharge hours to answer any questions and troubleshoot any problems.
Superusers will provide staff support and are the first-line resource to assist end-users with fundamental questions about workflow and functionality (McBride & Tietze, 2022).

Business Case

morganstuddard — 2024-02-05 09:57:24 UTC

Altering the workflow for the AVS and discharging patients will reduce the likelihood of patient readmission, adverse drug events, misunderstanding of medical problems, and non-compliance with follow up appointments and care.

This process is imperative to ensure complete funding and reimbursement for hospitals from governing agencies.

CMS created a Hospital Readmission Reduction Program (HRRP) that reduces payments up to 3% to hospitals with excess readmissions within a 30-day timeframe from the patient’s initial admission (Centers for Medicare and Medicaid Services, 2023).

jmeyers44 — 2024-02-05 21:02:12 UTC

jmeyers44 — 2024-02-05 21:02:31 UTC

jmeyers44 — 2024-02-05 21:02:41 UTC

Project Description

jmeyers44 — 2024-02-05 21:17:31 UTC

· This project aims to improve the discharge and education process of patients by making the AVS clear to read, include all important discharge information, and ensuring the patient knows what medications to take and when they were last given.

· Education provided to the patient with the AVS is extremely nurse dependent. This project aims to address this problem through automation based on patient diagnosis.

· the patient’s next follow up appointments are only sometimes listed on the AVS. Ensuring this is listed will help patients understand their next steps in care after hospitalization.

Future State

jmeyers44 — 2024-02-05 21:21:42 UTC

Test New Workflows and Processes

jmeyers44 — 2024-02-05 21:26:15 UTC

· A comprehensive testing strategy will need to be employed since this workflow redesign changes both work processes and implements new technology-based systems into the AVS.

· Gather user feedback.

· Develop a test environment for correctly pulling data and education materials.

· Utilize a combination of testing scripts and manual user testing to ensure accuracy of information.

· Measure time taken to pull data correctly.

Team Members

nanners1130 — 2024-02-06 21:05:53 UTC

For this task force, we would want to include a project manager, an informaticist, a lead physician, a lead registered nurse, a case manager, and a HUC or registration staff member who is responsible for scheduling patient appointments.
The Six Sigma methodology, for example, recommends keeping the teams to seven or eight people at most (Jotform, 2023).

Schedule

nanners1130 — 2024-02-06 21:08:26 UTC

For this process improvement, the task force has outlined an approximate timeline of 21 months.
The first nine months will be the start of the project. This is the time that the team will meet to discuss the goals and how to achieve them. Outlining how the process will be improved and the steps to make this happen.
The last 12 months of the process is when IT will be working on building the change into the EHR system.

How we will analyze and refine the workflows

nanners1130 — 2024-02-06 21:13:50 UTC

The primary goal of workflow analysis is to identify inefficiencies, bottlenecks, redundancies, and areas for improvement in the workflow, ultimately leading to increased efficiency, productivity, and cost savings (Numminen, 2023).
Flowsheets can be used to show the old steps in the process and where the changes will be to the new process. A visual example of how the process change will appear. The flowsheet is also used to look at efficiency and areas to reduce costs.

Support Required

nanners1130 — 2024-02-06 21:18:39 UTC

Informatics, IT, Project Management, Registered Nurses, Providers, Case Managers, and HUC or receptionist to schedule appointments.
Test group to use the updated and go over issues or problems.
Education team to help roll up the update to staff.

Benefit to Internal and External Customers

morganstuddard — 2024-02-06 23:36:55 UTC

Internal customers:

Easier to schedule follow up visits for patients
Automated input reduces workload
Less variability in information given to patients

External customers:

Quicker discharge process
Ensures patient receives education related to reason for hospitalization
Increased likelihood for medication compliance and attending follow-up appointments

Current State

morganstuddard — 2024-02-06 23:37:57 UTC

Questions

jmeyers44 — 2024-02-06 23:45:53 UTC

What is on the AVS at your facility and what would you want to see changed to improve it?

As a patient, what do you imagine to be the most frustrating part of the discharge process and how would you improve it?

As a project member, what would you change about this proposed workflow redesign?

References

morganstuddard — 2024-02-06 23:50:13 UTC

Conclusion

kelwood11 — 2024-02-07 00:11:34 UTC

In conclusion, this AVS task force aims to increase the accuracy of patient discharges, satisfaction, and care while decreasing readmission rates. Our task force used the flowchart method to identify inefficiencies in the after visit summary and discharge processes. These were identified through a current state analysis to be inaccurate medication schedules, lack of patient education, missing scheduled follow up appointments within the AVS. By learning about these inefficiencies, a future state process was developed to introduce automation and standardization across the discharge process. Ongoing project analysis should be considered when looking at the current workflow for case management as this process may have added additional burden to their current process.