Learning From Our Patients: How Patient Engagement Data Can Inform Clinical Practice Guidelines

September 26, 2018

At Lafayette General Health (LGH), our bariatric program was thrilled to be one of the early adopters of HealthLoop, along with our orthopedic service line and emergency department. The automated patient engagement solution has been instrumental in better supporting and guiding discharged patients, allowing care teams to address questions and concerns in a timely manner.

As a bariatric center of excellence, our bariatric care teams are committed to innovation and delivering high quality care to our patients. We rely on clinical protocols to provide an agreed upon framework for outlining the care that will be provided to our surgical patients. As new data and information becomes available, we reevaluate and update our clinical protocols periodically.

Since implementing HealthLoop, the platform has allowed us to gather patient-generated data to inform our bariatric clinical protocols.

 

Quantifying a Problem

Constipation is a common post-operative complication among bariatric patients. For that reason, our care teams had been following a protocol of prescribing two over-the-counter medications after surgery: a fiber supplement and a stool softener. Despite the protocol, we still regularly received phone calls and clinic and emergency department visits from sleeve gastrectomy patients dealing with constipation after surgery.

We faced a real challenge understanding just how many patients were struggling with constipation. Before HealthLoop, we didn’t have a simple method of quantifying the extent of the problem.

After our program implemented HealthLoop, we quickly pulled data that showed 40 percent of sleeve gastrectomy patients reported being constipated within four to six days after surgery. We knew we needed to make a change.

Knowing that constipation can be a preventable post-operative complication, we set out to get to the root of the problem. After ruling out other causes of constipation among this patient population, such as drinking too little water, we determined that we needed to change our constipation prevention clinical protocol. Based on conversations with other bariatric programs, we eliminated the fiber supplement and recommended a different stool softener to patients.

After the protocol change, our care teams immediately noticed that they weren’t receiving as many alerts through HealthLoop related to constipation. We ran another report to measure the impact of the change and were pleased to see that our numbers dropped significantly –  from 40 percent to 18 percent. That’s the power of patient engagement data!

 

A Performance Improvement Tool

As a bariatric center of excellence, we are required to conduct an annual performance improvement (PI) project for accreditation. After using the constipation protocol as our most recent PI project, our team has turned its attention to the next PI initiative.

We receive quite a bit of feedback from patients that they are not able to take in the required amount of water during the few days post-op. Our next PI project will examine water intake among post-operative bariatric patients. Depending upon what we learn from the data, we may change the way we educate patients about water intake either at their pre-op class or during post-operative rounding.

From a quality standpoint, HealthLoop makes it so much easier to pull data provided by patients and determine what our next step is and what we can do to improve our program.

 

Moving Into the Digital Age

All of our educational material prior to HealthLoop was in printed form. Our patients had been telling us that they really wanted the educational content at their fingertips – on their smart phones, computers, and other devices. They also wanted to be able to communicate with us electronically. If they had a concern about an incision, they wanted to be able to send us a photo and receive feedback.

HealthLoop supports these capabilities. Patients can send questions and photos through the platform and care teams are immediately alerted to concerning issues. When a bariatric patient is at the grocery store with a food-related question, they can now pull up the dietary guidelines on their devices to find the information they need. Previously, if they had forgotten to bring their paperwork grocery shopping, they would have had to call the clinic with their questions.

Our care teams have noticed a decrease in the number of phone calls to the clinic because patients are asking questions via HealthLoop or using the platform’s educational content to find the information they need.

 

A Winning Proposition

When we implemented HealthLoop, we expected to see patients learning from the platform, modifying behaviors and daily responsibilities for themselves. But our patients are teaching us as well. By engaging with our patients daily, we receive feedback about their recovery that helps us to modify the clinical protocols that we recommend for them. And that’s a win for everyone.



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Brooke Doucet earned her Bachelors of Science in Nursing from the University of Louisiana at Lafayette in 2000. In 2003, she began caring for post-operative bariatric patients. Brooke joined the team at Lafayette General Medical Center in 2011 where she became the Bariatric Manger. She then earned her certification as a Certified Bariatric Nurse through the American Society of Metabolic and Bariatric Surgery in 2013. Brooke develops, implements and revises processes to ensure outcomes are achieved and satisfactory to accrediting agencies for the bariatric program. She finds her work very rewarding and enjoys watching the transformation of her patients post-operatively.

Categories: Patient Engagement, Improved Outcomes, Patient Experience, Patient Safety

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