Viv

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Substitution of care
Viv
Posted on April 29, 2018 at 2:22 pm
Succesful projects on substitution of care

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On May 10, 2018, Viv commented on Reducing the number of non-urgent patients in the Emergency Department :

In the Netherlands we are allowed to send no show bills but only a few hosptials are doing it. In our hospital we recently debated again on this subject, as part as a “cut costs” project. In the end we decided not to send a bill for no show.
In our hospital it would bring up 400 k. But we also have to invest in administration and in the end send a summoner.
Experiences of other hospitals tells us that half of the people who do not show up won’t pay the bill. They probably are people with low income. So the trouble you have to make to get the money it huge.
And in the end, we are talking about health care and part of our patients our the fragile people who really need care and no bills so think about if it is really worth the trouble.
What we do is send a text message the day before the appointment as a reminder. Helpt a lot, worth the costs.

Good luck, Viviane

On May 10, 2018, Viv commented on Increasing Length of Stay :

Hi, some comments from my department

Managing expectation from patients is very important. So all patients are coming in on the day of surgery and they all know if they are going to be discharged the same day, or the next morning and so on.
The day before discharge, I speak with them at the end of the day to explain everything they want to know, so they do not see a doctor in the morning. So no waiting for docters or prescriptions, only for the nurse. If patients know this, they are happy with it.

Aside this, we also do value based health care project with other hospital eg breastcancer with 6 other hospitals. We compare also length of stay and that really helps doctors to change their protocols if they see that the same patients are released one or two days earlier in a comparable hospital. We help eachother in these 7 hospitals to eventually have the best care in all the 7 hospitals

good luck, Viviane

On May 10, 2018, Viv commented on How to reduce no shows :

In the Netherlands we are allowed to send no show bills but only a few hosptials are doing it. In our hospital we recently debated again on this subject, as part as a “cut costs” project. In the end we decided not to send a bill for no show.
In our hospital it would bring up 400 k. But we also have to invest in administration and in the end send a summoner.
Experiences of other hospitals tells us that half of the people who do not show up won’t pay the bill. They probably are people with low income. So the trouble you have to make to get the money it huge.
And in the end, we are talking about health care and part of our patients our the fragile people who really need care and no bills so think about if it is really worth the trouble.
What we do is send a text message the day before the appointment as a reminder. Helpt a lot, worth the costs.

Good luck, Viviane

On May 10, 2018, Viv commented on Addressing unnecessary emergency department (ED) use :

Hi Lisa,
I do not know if the following is possible in your place but in my hospital we tried to solve it as follows:

In the Netherlands it is normal to first call your primary dokter if you have a problem, 24/7. Only real emergencies go directly to the ER. But, despite this policy, a lot of people came in to the ER because they think they need ER help and the primary docter is not good enough.
When people come in to the ER we have to see them, we cannot send them back, because of an incident of someone who I think died aften been send away.
So now in most cities, at least in my hospital, after 5 pm till 8 am, we have a primary docter just 2 meters from the ER, same waiting room. Every patient who calls for their Primary docter will be seen there and if neccesary is send to the ER after that.
When a person just comes in, we have a nurse who tells them after traige to go to the primary docter desk or is taken in in the ER.
So at this point, nobody can come in at their own initiative.

Helps a lot!

good luck, Viviane

On May 10, 2018, Viv commented on No Show Rate :

In the Netherlands we are allowed to send no show bills but only a few hosptials are doing it. In our hospital we recently debated again on this subject, as part as a “cut costs” project. In the end we decided not to send a bill for no show.
In our hospital it would bring up 400 k. But we also have to invest in administration and in the end send a summoner.
Experiences of other hospitals tells us that half of the people who do not show up won’t pay the bill. They probably are people with low income. So the trouble you have to make to get the money it huge.
And in the end, we are talking about health care and part of our patients our the fragile people who really need care and no bills so think about if it is really worth the trouble.
What we do is send a text message the day before the appointment as a reminder. Helpt a lot, worth the costs.

Good luck, Viviane