Building a relationship from hospital to home

2 minute read

Building a relationship from hospital to home

< 1 minute read

Patients at St. Rose receive follow up calls from the same patient advocates that they meet in the hospital.

The Issue

Patient coaching post-discharge is a very important aspect of any transitions program. For it to be successful though, patients need to be receptive to our calls and willing to open up about any challenges they may be facing. It takes time to develop that trusting relationship and we didn’t want whoever was making the follow up phone calls to have to start from scratch.


St. Rose is a non-profit hospital in Hayward, CA. It has 217 beds and serves a diverse, low-income population including Spanish, Hindi, and Tagalog speakers. Their transitions program began in 2012 and is influenced by Project RED.

What We Tried

The patient advocate lets their patients know that they will be calling them after discharge. Patients see a lot of people during their stay at the hospital and sometimes don’t connect names to the people they saw. Our advocates can refresh their memory by saying, “I’m the one who was wearing the red scrubs,” or “I’m the one who gave you the red notebook to write your questions in.” That’s usually enough to remind the patients who the advocate is, and then they can build on the relationship they already developed in the hospital.


The strength of the relationship between the advocates and their patients is key to the success of our program. Once the patient remembers who the advocate is, there’s a natural comfort level to the conversation and the patient will give more than just yes/no responses to questions. We also don’t have the challenge of patients not answering calls because the advocate already let them know that they will be calling them regularly to check in on them.

Additional Benefits

Since the patient advocate took the time in the hospital to get to know the patient beyond their medical condition, they can ask about the patient’s kids, pets, or hobbies on the phone. This makes the call even more pleasant for the patient and results in them being more open to the advocate.

Program Challenges: Communicating with Patients

Patient and Family Challenges: Not Receptive to Our Help

Topics: After-hospital care, Patient engagement

Organizational Background

Organization Name: St. Rose Hospital

Location: St Rose Hospital, Calaroga Avenue, Hayward, CA, United States

Organization Type: Hospital