Healthcare News & Insights

4 keys to caring for vulnerable, high-risk patients

Hospitals are tasked with caring for members of many high-risk populations, such as senior citizens. Because Medicare and other payors are tying payment to patient outcomes, facilities must have a plan in place to manage the unique needs of patients with multiple chronic conditions and other significant health issues. 

As written in an article from Hospitals & Health Networks, older adults are often juggling several chronic conditions, such as diabetes and arthritis. Once they reach age 75, almost 80% of Americans have at least two chronic conditions. And as people age, the likelihood of them developing serious illnesses like cancer and heart disease increases, which makes them more vulnerable than younger patients.

Other high-risk populations also flock to hospitals, including the homeless and low-income patients. Many of them have chronic conditions that worsen because of various socioeconomic issues affecting how well they can manage their illnesses, from food insecurity to unstable living situations.

Addressing critical needs

Caring for these populations can be costly for facilities – and the healthcare system in general. Because of value-based payment initiatives, hospitals must make a sincere effort to boost population health while lowering costs when treating vulnerable patients.

Hospital executives can use this four-step strategy for guidance with creating targeted initiatives designed to address the needs of high-risk populations:

  1. Identify vulnerable patients. Specifically identifying your facility’s most vulnerable patients is essential to matching services to their actual needs. Use data in your electronic health records system to find out how much of your patient mix has multiple chronic illnesses and a history of hospital readmission. Look for commonalities to develop programs that’ll benefit the most patients.
  2. Match patients to needs. Once a plan’s in place, it’s time to start reaching out to patients who may benefit from the resources your hospital can offer. Whether it’s housing placement for the homeless or chronic disease management support for diabetics, let patients know how they can take advantage of these services during their next hospital visit.
  3. Train employees and keep them in the loop. Clinical staff need complete training for any initiatives that directly affect care protocols, including help with starting conversations with high-risk patients about any existing challenges they’re facing to stay healthy. Regular refreshers are helpful, and it’s also important to get their feedback throughout the process. Because clinical staff are on the front lines, their ideas are essential to developing programs that easily fit into their workflow.
  4. Track outcomes. The only way you’ll know if these efforts are successful is by reviewing outcome data on a regular basis. Monitor your facility’s mortality rates, emergency department visit patterns and 30-day readmission rates for members of high-risk groups. If the numbers aren’t improving, it may be time for a different approach.

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