Patient oversight can directly improve outcomes and patient satisfaction by reducing costly errors. Errors in post-acute care frequently occur from breakdowns in communication, failure to adhere to patients care plans, and patients being inadequately prepared for discharge. A patient’s oversight should start when they are first admitted into a skilled nursing facility. The patient’s medical history and current condition should be reviewed, clinical analytics should be generated to identify each patient’s baseline vital signs, and verification that the patient’s care plan is being adhered to by every shift should be ensured. It is critical that the clinical staff delivers consistent, quality care that can be verified through clinical notes and analytics to reduce errors. Skilled nursing facilities should strive to deliver excellent standardized care for every patient. They should also remember that the recovery process does not end upon discharge and neither should the patient’s oversight.
Generating a risk profile for each individual patient under a skilled nursing facilities care makes it possible to anticipate problems that may occur both while the patient is admitted in the facility, and eventually in the aftercare setting. The environment that each patient discharges home to is unique to that patient. A patient’s adherence to their care plan, and potential challenges that can impede their recovery at home can vary due to physical, social, and economic conditions. It can also be a challenge to stay engaged with patients during their transition home and as they work to get back into their normal daily routines. Some patient will return to supportive home environments such as senior living communities that provide additional support, while many others will leave the facility to recover at home, alone with minimal support from home health, care givers, or family and friends. Patients who lack support and who’s recovery process is not being overseen are at a substantially higher risk for being readmitted to the hospital.
OverSightMD maintains patient oversight through the entirety of the recovery process. Our proprietary clinical dashboards which are populated with patient data from all providers across the care continuum extend insights into their recovery long past the date of discharge. By sending each patient home with our Aftercare Assurance™, each patient will receive wellness assessments conducted by our care team on a scheduled, as needed basis. Through these wellness assessments we are able to identify and react to changes in conditions in real time, and ensure that each patient is receiving the appropriate, quality of care that will lead to a positive outcome.