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Reducing Diabetes-related Hospital Readmissions With Interactive Patient Engagement System

January 29, 2020
Reducing Diabetes-related Hospital Readmissions With Interactive Patient Engagement System

RALEIGH, N.C. and BOWLING GREEN, KY. (January 29, 2019) – The Medical Center at Bowling Green is reducing diabetes readmissions and increasing patient satisfaction by delivering education with the help of a patient engagement system from TeleHealth Services.

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Since implementing the TeleHealth Services SmarTigr system, HCAHPS scores have risen for medication communication and understanding care at time of discharge. Between 2017 – 2018, improvements in patient outcomes are documented as well, with a 15 percent decrease in the rate of kidney and diabetic complications after surgery and an all-cause readmissions rate decrease of three percent.  

 Diabetes is a serious public health epidemic across the nation but is even more prevalent in Kentucky, with the seventh highest rate of the disease in the nation. Currently, more than half of all adults living in Kentucky have diabetes or prediabetes. Diabetes is one of the most costly chronic conditions with an estimated annual expense of $5.2 billion in Kentucky, driven by complications that include heart disease, stroke, blindness, nerve and blood vessel damage, kidney failure, lower-limb amputation, and ketoacidosis.

Strengthening efforts to prevent new cases and improving self-management for those diagnosed are part of a statewide approach to addressing diabetes. Under evidence-based guidelines for treatment and lifestyle management, diabetes can be controlled and sometimes avoided altogether. 

“One out of every four patients admitted to our hospital has diabetes,” said Patient Educator Andrea Sturm, BSN, RN, CDE, MLDE.  “Education for these patients is essential to improving outcomes.” As the certified diabetes educator for the hospital, Sturm sees patients daily for bedside teaching. “On any given day, there can be up to 200 patients in our hospital with diabetes, so patient education is a shared responsibility. Dietitians, pharmacists, and especially staff nurses are charged with teaching patients about this disease and how to self-manage after leaving the hospital.”                            

Since 2013, Sturm has been tracking 30-day diabetes readmissions and reviewing each readmitted patient’s medical record for teaching. “We consistently see lower readmission rates among patients who receive diabetes education than among patients who do not.” 

Sturm knew the challenges of delivering education as the typical nurse’s time is in high demand for clinical responsibilities, leaving limited time for teaching. Many nurses also express concerns around the time it takes for disease-specific education so working as a team to deliver education to the patients and their families is essential. Cultural diversity, language barriers, and low health literacy are additional limiting factors for clinicians in their efforts to provide meaningful education.

Video-based education offered a strategic, consistent, and standardized approach. Diabetes education videos are prescribed by the clinician and accessed from the bedside television. Video views are automatically charted to patients’ electronic medical records. Videos primarily serve to supplement clinician-led teaching and can enhance the retention of information. The hospital implemented the TeleHealth Services SmarTigr interactive patient engagement system to help overcome literacy challenges and deliver easy-to-understand education about diabetes care and medication. The system also pushes additional condition-related messages through the television to the patient.

“As an example, we regularly see patients who have never had a glucose monitor, but they don’t always tell their doctors and nurses,” explains Sturm. The hospital displays information about glucose monitors on the TV and invites patients to call Sturm’s line if they don’t have a monitor. Sturm brings the needed equipment to the bedside and teaches patients and families how to use it.

“For many people, a hospitalization is a wake-up call,” Sturm said. “A medical crisis can be a powerful motivator. Even patients who aren’t feeling their best can be surprisingly receptive to learning about their conditions and the changes they need to make in order to feel better. The greatest benefit of a video on-demand strategy is that education is readily available whenever patients are ready to learn.” 

TeleHealth Services General Manager Kevin Colores said, “The Medical Center at Bowling Green is one of many examples of how hospitals are deploying technology to enhance the patient experience with information, entertainment, and integration services through network-based TVs. This successful diabetes education program is a blueprint that can be replicated throughout the nation to address many diseases, improving the health of patients and streamlining care and cost efficiencies for hospitals.”

About The Medical Center at Bowling Green

The Medical Center at Bowling Green is a 337-bed acute care facility and the flagship hospital for Med Center Health, the premier healthcare provider across a 12-county region in Southcentral Kentucky. The Medical Center at Bowling Green is a leader in healthcare innovation and excellence with its cardiac surgery quality scores far surpassing national standards. The health system also recently added the University of Kentucky College of Medicine – Bowling Green Campus, the first four-year regional medical school in KY. For more information, please visit www.medcenterhealth.org.