COPD insider

3 steps to saving costs by shifting patients from hospital to home

What’s the key to saving costs in patients with COPD? Shifting care settings. Discover three steps to get patients from hospital to home and cut your institution’s costs in the process.

 

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Change the setting — change the cost of care  

 

Quality care exists in many different settings. Whether it’s inpatient or outpatient, the goal in treating patients with COPD is always the same: getting and keeping them healthy at home. By delivering quality care in the least expensive care setting—the home—your institution may see a significant savings in cost. While this concept seems simple, shifting patients from hospital to home often proves to be quite challenging and expensive if done incorrectly.

 

So how can you ensure your patient’s transition is seamless? And, what are the most effective ways to keep them from being readmitted?

 

Read on to discover our experts’ three critical steps to save costs by shifting your patients from hospital to home today.

 

1.  Get respiratory therapists involved from the start

Shifting patients from the hospital—the most expensive care setting—to their home takes a team effort. But, one team member plays a key role from the moment a patient is admitted: the respiratory therapist (RT).

 

In order to make your patient’s admission as short as possible, RTs need to practice at the top of their scope. This means:

 

  • Identifying patient’s needs upon admission
  • Providing extensive care management
  • Anticipating obstacles that may occur in various care settings
  • Partnering with the patient and family to clear challenges prior to discharge

 

Once RTs have pinpointed potential obstacles, they can educate the rest of the team on how to contribute to getting the patient home sooner. And, with the rest of the team contributing, you can begin to move onto step 2.

Contributors

Becky Anderson

Becky Anderson, RRT

Manager,

Respiratory Care Services,

Sanford Medical Center

Les Duncan

Christine Cunningham, RRT

Director of Clinical Services

CHI Health at Home

Jill Ohar

Jill Ohar, MD, FCCP

Professor of Internal Medicine, Pulmonary, Critical Care, Allergy, and Immunological Diseases

Wake Forest University School of Medicine

Director of Clinical Operations

Wake Forest University Baptist Medical Center

Respiratory therapists have the highest technical knowledge to serve as a bridge from hospital to home.”

 

-Jill Ohar, MD, FCCP

Professor of Internal Medicine, Pulmonary, Critical Care, Allergy, and Immunological Diseases Wake Forest University School of Medicine

Director of Clinical Operations

Wake Forest University Baptist Medical Center

On the role RTs play in shifting care

 

-Becky Anderson, RRT

Manager, Respiratory Care Services

Sanford Medical Hospital

On the need to uncover a patient's story video
Icon of people and dollar signs

     

A glimpse into the real cost of inpatient care

 

The daily cost of home oxygen for Medicare patients is 1/268th of the cost of a one-day hospital visit1

2. Develop a quality discharge plan

 

Before any patient leaves your institution, a discharge plan needs to be set. But, not just any discharge plan; your plan needs to be well thought out and tailored to that specific patient’s needs in order to prevent a potential readmission.

Icon of bed

Numbers you can’t ignore        

 

More than 40% of patients with COPD end up back in the hospital after three months2

Brian Carlin
Discover how to keep your patients healthy at home with Brian Carlin’s
4 keys to sustainable readmission reduction

3.  Maximize their home care — minimize your cost

 

For patients with COPD, quality care shouldn’t slow down once they shift to a less expensive care setting. Often, home care is just as important as the inpatient care they received. It’s also valuable for more than just your patient’s health—it can significantly help the financial health of your institution.

In a six-month randomized study of 104 patients aged 75 and older with acute exacerbation of COPD, the mean total cost of
patients treated at home was $1,175.90  vs  $1,390.90 for patients treated in the hospital footnote 5
Icon of home and hospital and dollar signs
There’s a lot of opportunity to reach out to your patient post-discharge and affect the care we provide.”

- Christine Cunningham, RRT

Director of Clinical Services, CHI Health at Home

For example, evidence-based home care programs like the Transitional Care Model target older adults with complex needs. This model prepares patients and caregivers to manage COPD in the home setting. Home care programs like this have been shown to have6:

 

  • Fewer readmissions
  • Fewer total days readmitted
  • Lower mortality
  • Improved quality of life
  • Improved patient satisfaction after discharge
Icon of people and electronic devices

Tips for boosting your patient’s success at home        

 

  • Educate them on the importance of adherence to treatment7
  • Choose a device that fits into their life and addresses their medical need8
  • Set them up with a multidisciplinary pulmonary rehabilitation program9  

Start the shift of care today

 

Making a patient’s transition from hospital to home seamless isn’t always easy. It takes hard work and dedication from all team members across all care settings. The good new is it can be done. If you involve RTs from the start, develop a strong discharge plan, and invest in maximizing your home care efforts, this shift in care settings may be smoother than you initially thought. And, if you master this process, both your patients and your institution will reap the benefits.

References
1.
 Cost-effectiveness of homecare. American Association of Homecare Web site. https://www.aahomecare.org/issues/cost-effectiveness-of-homecare. Accessed June 29, 2017. 
2. Stephenson J. Improve discharge planning for COPD patients, says report. Nursing Times Web site. https://www.nursingtimes.net/news/reviews-and-reports/improve-discharge-planning-for-copd-patients-says-report/7015304.article. Published February 1, 2017. Accessed June 29, 2017. 
3. Tips for a successful COPD discharge. Do More With Oxygen Web site. http://www.domorewithoxygen.com/bid/221374/Tips-for-a-Successful-COPD-Discharge. Published September 21, 2012. Accessed June 29, 2017. 
4. 
Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2017 Report. http://goldcopd.org. Accessed June 29, 2017. 
5.
 Aimonino Ricauda N, Tibaldi V, Leff B, et al. Substitutive “hospital at home” versus inpatinet care for elderly patients with exacerbations of chronic obstructive pulmonary disease: a prospective randomized, controlled trial. J Am Geriatr Soc. 2008;56(3):493-500.
6.
Krishnan JA, Gussin HA, Prieto-Centurion V, Sullivan JL, Zaidi F, Thomashow BM. National COPD readmissions summit 2013: integrating COPD into patient-centered hospital readmissions reduction programs. Chron Obstruct Pulm Dis. 2015;2(1):70-80.
7. Bourbeau J, Bartlett S. Patient adherence in COPD. Thorax. 2008; 63(9):831-838.
8.
Ray SM, Barger Stevens AR. Choosing the right inhaled medication device for COPD. Am Fam Physician. 2013; 88(10):651-652.
9.
Lan CC, Chu WH, Yang MC, Lee CH, Wu YK, Wu CP. Benefits of pulmonary rehabilitation in patients with COPD and normal exercise capacity. Respir Care. 2013; 58(9):1482-1488.
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