Impact of care coaching on hospital length of stay, readmission rates, postdischarge phone calls, and patient satisfaction after bariatric surgery.

BACKGROUND: Bariatric surgery is well established as an effective means of treating obesity; however, 30-day readmission rates remain high. The Bariatric Care Coaching Program was developed in response to a perceived need for better communication with patients upon discharge from hospital and prior to being seen at their first postoperative visit. The lack of communication was apparent from the number of patient phone calls to clinic and readmissions to hospital. OBJECTIVES: The aim of this study was to evaluate the impact of the care coaching program on hospital length of stay (LOS), readmission rates, patient phone calls, and patient satisfaction. SETTING: The study was conducted at The Ohio State University Wexner Medical Center. METHODS: A retrospective review was conducted on patients who had primary bariatric surgery from July 1, 2013 to June 30, 2015. The control group included patients who underwent surgery from July 1, 2013 to June 30, 2014, before development of the program, and the experimental group was composed of patients who received care coaching from July 1, 2014 to June 30, 2015. Demographics, postoperative complications, LOS, clinic phone calls, and hospital readmissions, prior to the first postoperative visit, were collected from medical records. Patient satisfaction scores were collected from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey [HCAHPS]. Differences between study groups were assessed and P values <0.05 were considered statistically significant. RESULTS: There were 261 and 264 patients in the care-coach and control groups, respectively. The care-coached group had fewer patients with intractable nausea/vomiting (P = .0164) and a shorter mean LOS (P = .032). Subgroup analysis indicated that the difference in LOS was evident for laparoscopic sleeve gastrectomy (P = .002). There was no difference in readmission rates (P = .841) or phone calls to clinic (P = .407). HCAHPS scores demonstrated an improvement in patients' perception of communication regarding medications (59th versus 27th percentile), discharge information (98th versus 93rd percentile), and likelihood of recommending the hospital (85th versus 74th percentile). CONCLUSION: The Bariatric Care Coaching Program is an important new adjunct in the care of our bariatric inpatients. It has had the greatest impact on postoperative nausea/vomiting, LOS for sleeve gastrectomy, and patient satisfaction. Further studies are needed to evaluate how to use this program to reduce readmission rates and phone calls to the clinic.

Understanding patient satisfaction ratings for radiology services.

OBJECTIVE: Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments. CONCLUSION: Research results indicate that training providers to make simple modifications in their language and behavior during patient care can significantly impact patient satisfaction, which, in turn, can impact both quality-of-care ratings and the bottom line of hospitals. Training providers is a simple and cost-effective way to potentiate the clinical expression of compassion into improvement of patient satisfaction and financial reward, a national trend that no one in the game can afford to ignore.