Family Involvement in Patient Care Reduces Hospital Readmission Rates

By Jane Farrell

A program that allows family members of hospitalized patients to assist in their care improved healing and reduced readmission rates, according to researchers from a Utah health-care system.

The voluntary program, Partners in Healing, provides chances for family members to learn about, and help, with basic care for their loved ones – and that, in turn, helps them prepare for their responsibilities when the patient comes home.

A study of the program, which is being conducted by Intermountain Healthcare, was published in the February issue of the medical journal CHEST.

An additional benefit of Partners in Healing is that it improves communication between the family and the staff, said Michelle Van De Graaff, RN, of Intermountain Medical Center, who created and piloted the program.

During a patient’s initial encounter in the hospital, the bedside nurse introduces the program and families are asked if they want to participate.

Those who are interested are taught several basic skills that are appropriate for that patient, then given a badge that indicates to staff that they’re part of the care team and have access to drinks, snacks, ice, and blankets for their family member.

A checklist is taped to the patient’s door and program participants write what they do, such as helping with breathing exercises, assisting with activity, giving help to the bathroom, measuring urine output, recording how much a patient eats and drinks, and other relevant activities. The nurse then transfers the data into the computer record.

“These are simple tasks, but they give families a sense of control and knowledge about what they can and can’t do,” said Van De Graaff. “By inviting them onto the healthcare team, we’re also preparing them to take over care when a patient goes home.”

The various tasks a family member can perform are determined by the patient’s needs and the capacity of the family member, she says. “For example, families of heart failure patients learn to measure intake and output, while families of post-surgery patients are taught to focus on breathing exercises and activity.”

Partners in Healing is the first program in the field that shows that families acting as clinical care partners during hospitalization may reduce readmissions. In the study, researchers compared adult heart surgery patients at Intermountain Medical Center whose families participated in the program with those whose relatives did not.

Intermountain researchers looked at 30-day all-cause readmissions, 30-day all-cause mortality, length of stay, and the number of emergency room visits. Many family members who participated also completed a feedback survey.

The 30-day readmission rate was 65 percent lower for patients whose families participated in Partners in Healing, based on 200 matched pairs of patients. Researchers controlled the results for age, gender, and illness severity. There was no significant difference for the other outcomes.

Participant feedback showed that 92 percent of the patients said the program enhanced the transition from hospital care to home care, and 94 percent said they’d highly recommend the program to other families.

The program will now expand to the other 21 Intermountain Healthcare hospitals and will eventually be available on all Intermountain nursing units.