Post-Discharge Solutions

When patients are informed and understand their transitions of care, outcomes are improved.

The hospital to home transition is enhanced by CareNavigator™ keeping the patient connected to the same type of content which was provided in the hospital.

Rather than using a pillow speaker and a TV monitor, the recovering patient and family members now use a computer. Arriving home, the process is simple: The patient receives an email which provides a link and secure credentials. Logging in, the patient continues to be engaged in a HIPAA-compliant environment.

Designed to involve families in supporting the patient, this calendar-driven content makes sure the patient is informed and reminded, of key events:

  • Discharge instructionsCareNavigator home recovery solutions
  • Medication schedules and information
  • Rehabilitation schedules and information
  • Follow up appointments
  • Diet & Exercise videos and instructions
  • Maps and driving directions to physicians, care providers and the hospital

The same system of delivering alerts and surveys that took place when the patient was in the hospital continues post-discharge.

Outcomes and registry data is gathered and is automatically collected for clinicians to monitor. This data helps optimize outcomes by providing clinicians a view into patient's functional health and well-being.

The results:

  • Reduced readmission rates
  • More positive outcomes for the patient
  • Increased market share and enhanced loyalty for the hospital

Ongoing Education

To effectively bridge the transition of care, condition-specific information patients received during their hospital stay continues to be made available post-discharge. This gives patients who want to review educational content the opportunity to clarify their understanding and reduce complications.

Educational content specific to the home environment, such as information on home falls prevention, can be pushed as well, along with anything the patient's care team determines to be helpful and appropriate.

Because the patient continues to be informed post-discharge, levels of engagement achieved during the hospital stay may be enhanced at the home environment.

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Alerts, Reminders and Calendars

When the patient returns home, each day brings new responsibilities. These include adherence to medication schedules, showing up for medical appointments, and other events on the continuum of care.

CareNavigator is designed to help the patient manage and simplify this process... a process that can be cumbersome, confusing, and detrimental to the recovery process.

  • Email alerts are delivered to make the patient aware of necessary events.
  • Reminders, which have been determined and scheduled by clinicians in advance, reduce the risk of patient forgetfulness and can lessen distractions which may interfere with medication schedules.
  • Calendars give the patient a simple, centralized tool for the management of follow up care, therapy, and evaluation.

Collectively, this communication is the cornerstone of the patient journey of care. They are perceived as helpful, both by the patient, and by the family supporting the patient. Because this information is conveniently accessed through a secure, HIPAA-compliant connection on the home computer, privacy is assured.

CareNavigator doesn't just give the patient helpful information. It provides essential congruence and continuity for the journey of care.

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Family Involvement

When patients are discharged, their families are often at a loss when it comes to understanding their role. CareNavigator gives families a powerful resource.

Families, friends and loved ones no longer have to rely on asking the patient questions about their recovery. They are able to access clinicians' instructions, medication schedules and appointment calendars to support patient recovery.

Along with this information, families can view videos to better understand the patient's situation, which helps them provide the best possible support and care. Educated and informed family members are a key component in the post-discharge recovery process.

Hospitals which use CareNavigator to provide a better in-patient experience also understand the importance of engaging both patients and families post-discharge. This commitment to the journey of care is just one of the ways Skylight helps hospitals provide better outcomes.

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Outcomes and Tracking

The population-based data which is collected can be used to monitor both the overall effectiveness of treatment and specific aspects of procedures. As quality outcomes become increasingly important factors in how health care systems are being judged and reimbursed, the ability to gather, manage and analyze this data is essential.

As a result of the outcomes and tracking, physicians and medical groups benefit from:

  • The ability to evaluate and manage outcomes over time
  • The ability to analyze Pre-Admission and Post Discharge Outcomes
  • Reports provide data by both patient and population for viewing and analysis
  • The development of Care Maps to help promote services and the organization

Patients benefit from:

  • Enhanced outcomes
  • Greater understanding
  • Deeper levels of engagement

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