Penn Medicine Lancaster General Hospital (LGH) recently introduced Penn Medicine Connects, an automated outreach program that connects with patients after their hospital discharge. Starting in April, LGH piloted the program with two hospital units. All patients discharged home from those select units received an automated phone call within 24 hours of their discharge.
During the call, the patient or caregiver responding is prompted to use their phone keypad to answer a five-question survey. The survey questions, which are available in English or Spanish, are designed to help assess the patient’s health status and identify the potential need for assistance with understanding care instructions, obtaining medication, or scheduling a follow-up appointment.
Based on the patient’s response, an alert may be triggered to a nurse at Penn Medicine’s Center for Connected Care, who will review the patient’s chart and follow up directly with that patient.
“Most concerns can be resolved by the nurse; however, if additional care is needed, the nurse will escalate the issue to the patient’s primary care physician, surgeon or hospitalist,” said John Wood, MD, medical director, LG Health Community Care Collaborative.
Automated patient engagement tools, like Penn Medicine Connects, have been shown to reduce the number of readmissions, improve the patient experience, and allow for a more seamless transition following a hospitalization.
“Our new program allows the transition of care process to support a larger patient population. Our staff can focus on hospital patients requiring closer observation and care, while newly discharged patients automatically receive support and a pathway for direct intervention, should they need it,” Wood said.
The rollout at LGH will be in alignment with the system-wide program, so the patient experience is consistent across all Penn Medicine hospitals. As of May, the program has expanded and is now available to all LGH patients.