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Patient Experience Case Study - Banner Thunderbird
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Improving Patient Experience and Satisfaction by Extending Our Lines of Communication After Discharge

What was the challenge, opportunity or issue faced?

Banner Thunderbird faced the challenge of improving patient satisfaction post discharge from the Emergency Department by improving follow up care.

We’ve long heard about the value of Provider call-backs once discharged from the Emergency Department, and direct communication with a provider appeared the "Gold Standard” for discharge follow-up. We faced the challenge of timely follow-up on each and every discharged patient. It seemed unsustainable to contact 100% of discharged patients in a timely and consistent manner while still preventing physician burn-out and maintaining wellness. Patients are discharged from the ED 24X7, making consistent follow-up almost impossible. Two physicians attempted to pilot a program of call-backs, and while many times rewarding, it soon became impossible to efficiently follow-up with everyone due to time and personal constraints.

However, through the workings of TEXTRAMOBILE and collaboration with Banner Thunderbird Emergency Department medical providers, the TextConnect system was developed. Through the use of text messaging, each discharged patient from the ED is contacted and a follow-up connection initiated.

It is well known that cell phones are quickly becoming the preferred media of communication, and it was soon discovered that through "texting” patients were more apt to respond to follow-up communication. This was validated from many received texts, including this one from a patient:

"Love the text messaging system. I check texts more than I answer phone calls purely for convenience. Thank you for following up.”

What did you do to address it?

Russ Forsberg, a PA, answering a call.Through this new, innovative application of a communication media, patients are contacted soon after they leave the ED with a follow-up text message sent to their phone to check up on the patient the next day. By doing so, the patients are able to contact a medical provider, Physician Assistant, to answer and receive medical direction for any problems or situations that developed post discharge. As another patient writes:

"My visit w/ ur hospital, I would rate #1. I especially liked the immediate texting, showing the extra effort & concern 4 ur patients. Thanku”

With this method, real time follow-up and conflict resolution is achieved as greater than 90% of patients receive direct follow-up within 30 minutes of connecting with the system (TextConnect) and contacting a provider with questions or problems. Additionally, records of each contact are maintained and are able to be integrated into the patient’s chart for risk management.

Patients are also contacted 3-5 days later and receive a survey text requesting their rating of their care in the Emergency Department. With over a 30% response rate, it’s not uncommon to receive texts similar to this from a patient:

"it was even nice that you’re checking up on me to see how I am doing. Most hospitals would not do this. I am very happy with your service”

Any texts noting a poor patient experience are automatically and immediately directed to the Emergency Department leadership and followed up personally with a phone call from the physician or nursing director.

What were the outcomes?

Patients embraced this new TextConnect system, as greater than 90% of patients agreed to sign up for this service.

Connecting with the patient and providing an "open door" to care post discharge is recognized by our patients. Not only do we see a rise in our patient satisfaction scores, but we receive many (unsolicited) positive comments that we share with the physicians and staff thus encouraging and reinforcing the positive patient experience they have created.

"Excellent experience, very courteous & professional. Especially liked the text message from Banner staff to check on patient. This is going above & beyond after discharge. Thank you very much.”

Approximately one third of discharged patients use the TextConnect system to answer persistent or new questions regarding their discharge care. Data suggests that this is more prevalent in our pediatric population. However, one adult discharged patient with a DVT used the system when developing some abnormal chest discomfort and was told to return immediately....... later having a PE diagnosed!

Emergency medical providers like the system due to the ease of administration while also preserving physician wellness. They additionally appreciate the feature that allows them to directly contact their patients through text without divulging their own personal contact information.

The patient satisfaction team in the ED has actionable data as they receive real-time feedback on patient care at rates never before achieved, and they have the ability to receive immediate feedback on any target area of weakness as we have the ability to change survey questions as we see fit.

With our TextConnect texting project, an entirely new line of communication is established. With over 30% of our discharged patients utilizing this service, Banner Thunderbird is extending the care to our patients through ongoing follow up, medical direction, conflict resolution, risk reduction and an improved patient experience.

About Banner Thunderbird Medical Center
Nonprofit Banner Thunderbird MedicalCenter opened its doors in 1983 and has been growing ever since to meet the health care needs of the communities in the northwest area of metropolitan Phoenix. The hospital is currently ranked one of the top hospitals in the Phoenix metropolitan area by US News & World Report and is a recent recipient of a prestigious "Best of the West" award from Westmarc in recognition of the hospital's contributions to the region. The 890,000-square-foot acute-care facility is on 33 acres on the southwest corner of 55th Avenue and Thunderbird Road in Glendale, Ariz. We are currently the fourth largest hospital in the Phoenix metropolitan area with 513 licensed beds.

Our Mission: "We exist to make a difference in people’s lives through excellent patient care

Our Vision: "We will be a national leader recognized for clinical excellence and innovation, preferred for a highly coordinated patient experience, and distinguished by the quality of our people.”

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