Patients frequently need help understanding health information to navigate care in our complex medical system. Healthcare encounters – especially those in acute care settings – can be emotionally charged and intimidating experiences for patients, oftentimes leaving them with questions they may be too apprehensive or distracted to ask during their stay.
In a November 2022 survey by Wolters Kluwer, 66% of patients reported having questions after a healthcare encounter. Patients frequently fail to retain health information shared during their visit due to the stress of being hospitalized and feeling overwhelmed with information upon discharge. Studies have shown that 40-80% of the medical information patients are told is forgotten immediately, and nearly half of the information retained is incorrect.
The lack of understanding of health education can put anyone, regardless of health literacy level, at risk of misunderstanding or missing important information about their follow-up care, leaving patients and hospitals more likely to suffer poorer outcomes, higher readmissions, and longer lengths of stay (LOS).
Overcoming Patient Education Challenges with Virtual Nursing
Properly educating patients about their condition and how to care for themselves after discharge can transform patient outcomes and improve the patient experience. Few clinicians would argue the importance of patient education but providing it in the hospital setting is a challenge for care teams as well as patients. Finding the time to educate patients and families, among all the other tasks nurses must juggle, can be daunting, particularly as workforce shortages persist.
That’s where virtual nurses come in.
In today’s telehealth-enabled world, an experienced remote nurse can perform patient education and discharge preparation, accomplishing many of the tasks that typically fall to floor nurses to support, including:
- Accurately collecting the home medication list
- Providing follow-up care instructions
- Reviewing signs and symptoms to look out for
How it Works: Virtual nurses work with care managers to obtain the patient discharge list. The remote RN cameras into the patient room via a hardwired A/V solution or a cart-based telehealth endpoint. The virtual nurse, with the patient, performs a review of the patient’s medications, post-discharge activity, and when to next follow up with their doctor. The virtual nurse can also include the patient’s family or caregivers in the discharge education session.
For post-surgical patients, this process might include dressing change instructions. For a patient with a respiratory condition, discharge prep might consist of training on how to use a new inhaler properly. For a diabetes patient, patient education could entail how to administer insulin and basic dietary recommendations. In each case, the virtual nurse can perform teach or talk-back education with the patient to ensure they understand the information they’ve been given.
The Clinical and Financial Impact of Virtual Nursing
Virtual nurse workflows related to patient education and communication can have a measurable impact on patient outcomes and experience.
Reduce Readmissions
Hospitals can lose up to 3% of each Medicare payment for a year due to higher-than-anticipated readmission rates. Hospitals saw $320M in Medicare payment reductions due to readmissions for 2022. Hospitals can reduce the potential for readmissions by using virtual nurses to empower patients and in-home caregivers through quality health education that supports discharge readiness. Armed with accurate information presented at the right time, patients can make better decisions and take a more active role in their care, which improves outcomes and helps reduce rehospitalizations.
Shorten Length-of-Stay
Exceeding the predicted LOS can cost hospitals as much as $91,000 per stay. Increased LOS is also associated with reduced bed turnover, increased chance of hospital-acquired infections, lower patient satisfaction, and decreased likelihood of recommending the hospital. Use virtual nurses to start discharge processes earlier so there is only a short summary on the day of discharge, which is less apt to overwhelm the patient, and the patient is released in a timely manner.
Improve HCAHPS Scores
Half of HCAHPS patient satisfaction measures – directly impacting hospital and provider reimbursements – focus on communication between the patient and healthcare team. Low HCAHPS scores can hurt the hospital’s reputation and limit funding received from Medicare. Providing patients access to virtual nurse support and personalized education can restore their sense of control over their health. Patients feel valued when the care team communicates with them in a way they can understand and are more likely to recommend the hospital as a result. Informed patients are also more engaged in their care and see better long-term outcomes.
Deploying Virtual Nurses to Support Patient Education
Here are a few guidelines to help you build an effective virtual nursing program designed to support patient education:
- To close communication gaps, get the virtual nurse in early to get the plan of care going and keep the care team in step. Virtual nurses should engage RNs, care managers, patients, therapists, providers, and families as appropriate.
- The education process should start at admission and be consistent rather than a hurried one-off task at the end of an acute care stay. Initiating conversations around follow-up care early on gives patients time to ask questions prior to discharge.
- Identify the learner, whether an in-home caregiver, hired help, or another resource, and include them in patient education when possible.
- Implement train-the-trainer programs to support and standardize patient education and communication practices.
- Ensure you have resources in place to overcome language barriers. Language accessibility is vital to equitably empowering all patients, and its accommodation is required by law. When considering language access solutions, assess how easily the virtual nurse can bring an interpreter into virtual calls.
- Use teach-back methods to ensure patients understand the information provided at discharge. Ask patients to explain in their own words the necessary steps to support their health and the next steps in their care journey.
- Show-me methods allow care team members to verify that patients understand how to operate any medical devices that may be part of their follow-up care.
- Incorporate best practices to overcome low health literacy into patient communications. These include avoiding medical terms, limiting information to three to five key points, and using education written at a fifth-grade reading level.
While many of these concepts are familiar to healthcare teams, introducing virtual nurse resources into workflows lays the foundation for more empowered patients, improved clinician experience, and greater financial solvency. These hybrid care models are rapidly evolving to play a pivotal role in strengthening patient communication, care processes, and outcomes.
This article was originally published in the Journal of mHealth.