St. Rose created a non-clinical transitional care team to supplement the clinical care that nurses and physicians provide.
When we first began our program, we didn’t have the budget to hire additional staff and we asked for volunteers from the nursing staff to help with enrollment and follow up phone calls. Project Red, the model we were following, is very nurse-driven, so it made sense to start there. It wasn’t sustainable though. Nurses already have so much on their plate and we were adding to their workload when they were only volunteers. There were also gaps in the patient’s care because not all of the nurses were participating and, for those that were, their shifts were always changing. So if a patient had questions after discharge, we couldn’t just give them a number to call—it would depend on who their nurse was and whether they were on shift. Ultimately we decided the nurses should focus on the clinical quality of care and we should find another way to run the non-clinical portion of Project Red.
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
Using our grant funds, we hired patient advocates for our program. Since our nurses could focus on the clinical side of things, we realized our patient advocates could be non-clinical. Rather than clinical knowledge, we hired patient advocates who have key customer service qualities. They genuinely care about our patients and know how to connect with them at a deeper level so that they can really help them. One of our most successful patient advocates was a makeup salesperson before coming to the hospital.
We’ve been able to create a much stronger program without sacrificing quality of care. Our patient advocates have more time to spend with each patient and therefore develop stronger relationships. Previously, patients would feel bad asking the nurses a lot of questions because they could tell the nurse was very busy. This is no longer a problem because the entire role of our patient advocates is to be there and help the patients answer questions. We can also give patients a phone number to call if they have any questions after discharge because a patient advocate is always manning the phone line.
This new role has really been key to the success of our program. We are supplemental to the care that patients receive, so we can focus on their experience while the clinical team focuses on their care.
Since non-clinical staff are not as expensive as nurses, we were able to hire more patient advocates with our grant and therefore help more patients.
An unexpected benefit of hiring patient advocates is that it helped gain buy-in from the nursing staff. They were grateful that this team could take the additional transitional care duties off of their plate and were fully supportive of the work we were doing since they had experience doing it themselves.
We found the most success when we looked for our patient advocates outside of traditional hiring channels. Since our advocates are liaisons between the patients and the clinical team, they don’t need a heavy medical background. Our advocates are people who are easy to talk to and genuinely care about the patients they work with.