Implementing Teach-Back
Throughout HCMC
November 8, 2012
RARE Action Learning Day
Jennifer Rudolph, HCMC
Structure
•
•
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•
Performance Excellence Department
Manage Organizational Initiatives
Advise on the Projects to Implement
Facilitate & Manage the Project
Future Process
Medication
Reconcillation
Patient
Admitted
Review
criteria to
categoriz
e into
H, M, L
MEDIUM
Medication
Reconcillation
Medication
Reconcillation
48
hours
24 hours
Discharge
summary
sent to PCP
Follow-up
appointment
made
Follow-up
appointment
made
Medication
Education &
Discharge
Instruction using
teach back
DISCHARGED
LOW RISK
MEDIUM RISK
HIGH RISK
Hospital Stay
Follow-up
phone call
Discharge
summary
sent to PCP
Home care
visit
Follow-up
phone call
(24-48 hours)
72
hours
120
hours
Follow-up
appointment
occurs
Home care
visit
Follow-up appointment occurs
Medication education and
discharge instruction using
teach back
96
hours
Follow-up
appointment
occurs
Ho s p
Medication
Reconciliation: TBD
Ca
Pri
ma
ry
re
S
Ca
tl y
cia
pe
Discharge Follow-Up
Phone Calls: Implement a
process based on best
practices that provides
patients in the high and
medium risk categories a
follow-up phone call within
24 hours (high) and 48
hours (medium).
Follow-Up Appointments:
Follow-up appointment
occurs within 3 days (high
risk) and 5 days (medium
risk) of discharge.
Redesign of Case
Management: Redesign case
management to incorporate
workflow changes that align
their work with the goals of
the organization, and that
creates a more patient and
family centric model.
re
lth Ca
Criteria Review: Use best
practices and HCMC
experience, to develop and
implement a process, to
assess inpatients for their
admission risk.
Program Objective:
Improve clinical processes
and tools to communicate
and optimize the patient’s
health after hospitalization to
decrease avoidable hospital
readmissions.
Skilled Nursing Facility
Discharge Summary:
Within 24 hours of
discharge ensure
discharge summaries
are available to PCP for
all patients.
Epic AVS: Develop
standard work for
completion of AVS that
meets regulatory
requirements, is patient
friendly, bases for teachback, & contains pertinent
information.
e Hea
Ho m
re
Teachback: Operationalize a
process, using best practices,
that supports nurses,
pharmacists, and providers
with applying teachback to
education patients on
medications and discharge
instructions.
ice
Every Project Has A Charter
Timeline
August
2012
April 2012
Teach-back
project started,
planning phase
March
2012
Teachback chosen
as a project
June 2012
Approved for all
of HCMC
By December
2012
Started Provider
Education &
Plan
Training for New
Employees
Implemented
May 2012
July 2012
Fall 2012
2 day workgroup to
develop training
- initial focus
inpatient
Teach-back at
ReNEW
Continued
Organizational Training
(Ambulatory, Pharmacy,
etc.)
Defined Training Objectives
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Define teach-back
Know the benefits of using teach-back
State expectations of using teach-back at HCMC
Demonstrate use of teach-back
Training Plan
Staff
Training
Hold Staff
Accountable
Help
Hardwire
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Training slides available
Video
Handouts
Competency Check-Off
• Patient Rounding
• Competency Check-Off
• Teach-back is for ALL disciplines for ALL
education
• Coach staff on open ended vs. yes/no
questions
• Praise them when you observe teach-back
• Be the example
Benefits
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Organization: Standard Teaching Method
Operational leaders: Dedicated Project Management
Patient care units: Team Environment
Patients: Increased Understanding and Compliance
C-Suite: Fewer Avoidable Readmissions
Sustainment
• Hardwiring
• New Employee Education
• Integrated into other education &
programs
• Becoming the culture at HCMC