7 Tips to Raise Patient Engagement to Reduce Readmissions

Empower your patients for better outcomes

Actively engaged patients understand their health well. They feel empowered to be proactive toward health management.[1] Daily decisions like eating a healthy diet, taking medications correctly, or getting exercise come naturally, leading to better outcomes.

A meta-analysis of 48 studies found patient engagement has a significant impact: Engaged patients had better control of cholesterol and triglycerides, got more pap smears and mammograms, didn't smoke as much, had better control of depression, and were less likely to be hospitalized than patients with low engagement scores.[2]

Building engagement is essential to achieving the best outcomes for your patients. But it can be challenging. Below, we explore 7 strategies you can use to encourage your patients to take ownership of their health.

7 Tips to Increase Engagement

1.  Share decisions. Multiple studies report that shared decision-making improves compliance and helps patients take an active role in their care.[3]

It may feel unnatural for providers to approach care decisions collaboratively, but unilateral decision-making does not lead to good outcomes.

When they are not involved in decisions, patients tend to ignore doctor’s orders: Up to 50% don’t follow treatment plans fully[4] and 50% don’t take medications as prescribed.[5] A study published in the Patient Experience Journal found that patients who were not involved in decisions had a 34% higher chance of hospital readmission.[6]

2.  Teach to activate. Being engaged in your health management is only possible if you clearly understand what you are doing and why. To promote understanding, encourage patients to participate actively in teaching. Active participation in discharge teaching lowers readmission rates.[7]  

When you teach, encourage your patient to ask questions. Check their understanding of instructions and create the opportunity for discussion by having them restate what you taught, called “teach-back.” In one study, using teach-back improved patient’s understanding of health concepts by 37%.[8]

3.  Provide written materials and present discharge instructions in a variety of ways to take advantage of your patient's learning style. Referring to printed discharge instructions when teaching improves information retention.[9] If your patient does not remember something after they are home, having a reliable reference is crucial.

In one study, patients who did not get written discharge instructions had a 24% higher chance of readmission.[3]

4.  Use digital tools. Digital tools can provide easy routes for patients to engage with their providers and ask questions. The care team can use digital platforms to check in.

In the post-COVID-19 environment, it is no surprise that digital communication is on the rise. According to the 2023 State of Healthcare Customer Experience Benchmark Report, 59% of U.S. healthcare consumers prefer digital communication with their providers over traditional communication.[10]

5.  Make a personal connection. The provider-patient relationship can significantly impact the patient's engagement in their care plan. Patients want to feel heard and know their opinions are respected. Studies show patients who like their doctor are much more likely to trust the treatment plan, be active care partners, and be comfortable asking clarifying questions.[11],[12]

6.  Assess social circumstances. Patients may understand how to manage their health but lack the resources to do so. Not only does this stop them from being proactive, but it can also be discouraging. Some potential barriers include:

• Lack of transportation

• Lack of access to healthy food choices

• Lack of safe and affordable housing

• Lack of access to prescriptions

• Lack of coping skills due to poor support networks or mental illness

Assess your patient’s financial and social circumstances and connect them with resources to overcome barriers.

7.  Invest in follow-up. A follow-up appointment with a primary care doctor within 7 days of discharge can lower readmissions,[13] but engagement shouldn’t stop then.

Create systems that make continuous connection your default. Some potential ways to stay in touch after patients go home are phone check-ins, automated texts, and newsletters.

Make a goal to check in with patients once a month. Even something as simple as branded education materials patients can refer to when questions arise can keep you and their health fresh in their mind.

Take advantage of multiple approaches to encourage health ownership in your patients. Build trust and understanding with strong relationships and individualized teaching. Help patients overcome barriers and maintain contact to promote active participation and the best outcomes.

References:

[1] Bombard Y, Baker GR, Orlando E, et al. Engaging patients to improve quality of care: a systematic review. Implement Sci. 2018;13(1). doi:10.1186/s13012-018-0784-z

  Research shows fewer readmissions when patients are engaged in their health care.

 Wilcox D, McCauley PS, Delaney C, Molony SL. Evaluation of a hospital: Community partnership to reduce 30-day readmissions. Prof Case Manag. 2018;23(6):327-341. doi:10.1097/ncm.0000000000000311

[2] Marzban S, Najafi M, Agolli A, Ashrafi E. Impact of patient engagement on healthcare quality: A scoping review. J Patient Exp. 2022;9:23743735221125440. doi:10.1177/23743735221125439

[3] The SHARE Approach—Achieving Patient-Centered Care with Shared Decision-making: A Brief for Administrators and Practice Leaders. Ahrq.gov. Accessed November 21, 2023. https://www.ahrq.gov/health-literacy/professional-training/shared-decision/tool/resource-9.html

[4] Gold DT, McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119(4 Suppl 1):S32-7. doi:10.1016/j.amjmed.2005.12.021

[5] Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26(3):155-159. doi:10.5001/omj.2011.38

[6] Kemp KA, Quan H, Santana MJ. Lack of patient involvement in care decisions and not receiving written discharge instructions are associated with unplanned readmissions up to one year. Patient Exp J. 2017;4(2):13-22. doi:10.35680/2372-0247.1205

[7] Trojano ML, Rucker G, McGillen B. Using standardized whiteboards to improve patient engagement. J Patient Exp. 2022;9:23743735221103030. doi:10.1177/23743735221103030

[8] Mahajan M, Hogewoning JA, Zewald JJA, Kerkmeer M, Feitsma M, van Rijssel DA. The impact of teach-back on patient recall and understanding of discharge information in the emergency department: the Emergency Teach-Back (EM-TeBa) study. Int J Emerg Med. 2020;13(1). doi:10.1186/s12245-020-00306-9

[9] Townshend R, Grondin C, Gupta A, Al-Khafaji J. Assessment of patient retention of inpatient care information post-hospitalization. Jt Comm J Qual Patient Saf. 2023;49(2):70-78. doi:10.1016/j.jcjq.2022.11.002

[10] 2023 Benchmark Report: The State of Healthcare Customer Experience. Smartcommunications.com. Accessed November 20, 2023. https://www.smartcommunications.com/resource-center/white-papers-ebooks/2023-benchmark-report-the-state-of-healthcare-customer-experience

[11] Bennett JK, Fuertes JN, Keitel M, et al. The role of patient attachment and working alliance on patient adherence, satisfaction, and health-related quality of life in lupus treatment. Patient Educ Couns. 2011;85(1):53–59

[12] Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903-918. doi:10.1016/0277-9536(94)00155-m

[13] Wiest, D., Yang, Q., Wilson, C., & Dravid, N. (2019). Outcomes of a citywide campaign to reduce medicaid hospital readmissions with connection to primary care within 7 days of hospital discharge. JAMA Network Open, 2(1), e187369. https://doi.org/10.1001/jamanetworkopen.2018.7369