Automated Wellbeing Checks by Text and Email Enhance the Care of Discharged Emergency Department and Immediate Care Patients

In 2008, the health system's program to contact discharged emergency department (ED) and immediate care (IC) patients by telephone was recognized as a best practice by the Robert Wood Johnson Foundation. Three years ago, the health system further innovated by implementing an electronic communication system.

Currently, each year, 100,000 patients are sent a survey link by email or text message in English or Spanish after they are discharged. Patients can use any device to complete the brief well-being check. Automated notifications are forwarded to the ED charge nurse or case manager when patients require intervention, as is necessary in 2 percent of cases and 8 percent of respondents.

The first question is, 'How are you feeling today?' When a patient answers 'worse,' which 3.8 percent of respondents do, a fax is sent to the ED using the same workflow process that is used when reconciling a patient's positive lab test results. The charge nurse reviews the chart, consults the physician and calls the patient with advice. The second question is, 'Do you have any questions about home care, medications or follow-up appointments?' When a patient answers 'Yes,' as 4.4 percent of respondents do, the system alerts case managers, who respond to aftercare issues via email or text message using a built-in module.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/