Pilot Telehealth Program Improves Patient Care Transition From Hospitals to SNFs

With reported high transition-related patient safety errors associated with the release from hospitals to skilled nursing facilities (SNFs), study authors investigated the impact of implementing of a pilot telehealth videoconference program.

The pilot program was executed at 2 academic hospitals among patients being discharged to participating SNFs. Researchers retrospectively examined patient safety errors, process measures, and hospital readmissions. Findings were discussed at weekly conferences held from July 2019 to January 2020.

Researchers utilized the Reach, Effectiveness, Adoption, Implementation, Maintenance model and reported statistics on patient safety errors, patient and index hospitalization characteristics, and conference process measures.

Authors of the study reported the use of logistic regression models fit to compare the probability of 30-day hospital readmission in patients discharged to participating SNFs across 7 months prior to after the telehealth project to conduct an intention-to-treat (ITT) analysis.

During 26 telehealth videoconferences, hospitals and SNF providers discussed 263 patients (67% of eligible patients) with 7.7 minutes being the mean discussion time per patient. Per patient the median prep time reported was 10.3 minutes for the hospital clinician and 24.2 minutes for the hospital pharmacist.

Findings show safety errors among a total of 327 patients and researchers noted that of these errors, 43% were related to medications and 54% were related to communication.

In addition, the probability of readmission across pre-implementation compared with the program period demonstrated no statistical significance (OR 0.95, [95% CI 0.75, 1.19]).

“A pilot care innovations telehealth videoconference between hospital-based and SNF provider teams was successfully implemented within a large health system and enhanced care transitions by optimizing error-prone transitions,” concluded study authors. “Future work is needed to understand process flow within nursing homes and its impact on clinical outcomes.”

Reference:
Bellantoni J, Clark E, Wilson J, et al. Implementation of a telehealth videoconference to improve hospital-to-skilled nursing care transitions: preliminary data. J Am Ger Soc. Published online March 25, 2022. doi:10.1111/jgs.17751.