Patient Experience Week: Orchestrated Care with a Personal Touch

April 22, 2019

Patient Experience Week: Orchestrated Care with a Personal Touch

In honor of Patient Experience week, we want to celebrate our staff for all they do to make an impact on our patients every day. Each of our employees play an important role in making sure our patients have a positive experience at each visit.

Today, we want to share how an idea from one Central Indiana Orthopedics’ employee, Natalie McClintick, sparked a program that has made a significant impact on our surgery patients. Natalie has a very unique role at CIO as a Nurse Practitioner Case Manager. Prior to joining CIO, she worked at a local hospital for 19 years in an orthopedic role where she coordinated the care of CIO’s surgical patients and taught a Total Joint Class for all patients undergoing a total joint replacement. Being this involved in the patient’s care prior to surgery, Natalie developed a relationship with each patient their family. Her communication with patients also continued after they went home.

Recognizing a gap in care

Natalie shared with us how she first recognized a gap in care after patients were discharged from the hospital. The patient receives a great amount of information regarding wound care, activity, medications, etc. upon discharge and they are also most likely under the influence of narcotic pain medication. It became evident that even though the same information was heard prior to surgery and upon discharge it wasn’t enough – patients were still overwhelmed.

There would be times when Natalie would call a patient a few days after they left the hospital and she would ask if they had any questions about their discharge instructions. What Natalie thought the patient heard and understood was nowhere close to what they absorbed. “I saw a significant gap in care when the patients went home because they were still very confused about who to contact if they had questions,” Natalie said. “In the hospital, they are given many business cards from a multitude of people who come in the room. Although these patients are educated people, they still need help – one single person that they could contact at any time to answer questions and help guide them.”

Putting ideas into action

Fast forward to her role at Central Indiana Orthopedics, Natalie’s job is an elevated extension of what she was doing in the hospital setting as a Nurse Practitioner. After attending a conference, Natalie brought back the idea to help streamline care and prevent readmission – a bracelet that all of our patients would wear when they are discharged from the hospital after surgery. The bracelet (shown below) has Natalie’s name and contact information on it, so patients have that “one person” to contact with any questions or concerns during recovery.

The phone number goes directly to Natalie’s cell phone. “Patients call me with questions and are always surprised when a nurse practitioner answers – they must think they are going to get an answering machine,” Natalie said. “If I feel like the patient needs to be evaluated, I will drive out to their home and assess them. If they are having a medical concern and not an orthopedic concern, I will assist them in calling their primary care physician’s office if I feel like they need to be seen urgently.”

Natalie’s most frequent home visit is a dressing change. Before implementing this service, a patient would normally have to make a visit to our office, or even the emergency room, but now Natalie has eliminated the need for a patient to get out of their home. Additionally, home visits allow Natalie to see the incision and alert the surgeon of any potential problems.

Building a team to provide orchestrated care

An equal part/champion in this service is Natalie’s “right hand” person, Crystal Brashears. Crystal is a Registered Nurse Case Manager and helps to coordinate all home visits and communicate with the surgeon details of the patient’s care. The surgeons are in constant communication with Natalie and Crystal regarding any concerns they have about a patient’s recovery, and patients feel more comfortable knowing they have a nurse practitioner and registered nurse at their disposal.

“I like calling what we do ‘orchestrated care’ because we know that each patient is unique and requires some careful planning with one person helping to conduct the entire episode,” Natalie shared. “Having a plan in place helps not only the patient, but also helps the family to prepare and feel more comfortable after the hospital stay – they have that one person to turn to with questions.”

Since Natalie/CIO started this program in 2018, our readmission status has dropped significantly. Being there every step of the way for our patients is what Natalie and Crystal love most.

Natalie, Crystal and all of the Central Indiana Orthopedics’ staff – THANK YOU for all that you do to create a positive experience for our patients. You make a difference in patient care and you are appreciated!

Watch the video below to learn more about this program and a special bond Natalie made with her first home visit patient, Chuck.