Video Ethnography Reduces Hospital Readmission Rates for Elderly Heart Patients

Videotaping vulnerable patients and their caregivers in their care settings and analyzing their interactions helped to reduce those patients’ readmission rates by nearly 5 percent, reports Kaiser Permanente in a new paper published in Health Affairs.

Hospital readmission rates at the Kaiser Permanente South Bay Medical Center in California dropped from 13.6 percent to 9 percent in six months as a result of using video ethnography, ethnography being the branch of anthropology dealing with the scientific description of specific human cultures. Video ethnography, designed as part of Kaiser’s quality improvement program, involves videotaping interviews and observations of patients and caregivers in real time to identify care gaps, unmet patient and caregiver needs, and effective practices. The tool has proved particularly effective with vulnerable populations such as frail elders, patients nearing the end of life, and those with multiple chronic conditions. These populations are usually not well represented in other quality improvement approaches such as focus groups and patient advisory councils, the report says.

The process involves videotaping patients and caregivers as they are being interviewed, and observing how they interact with each other in a clinic, hospital or at home. The team then reviews the video and identifies recurrent themes, such as patient and caregiver needs and choices, care gaps, and effective practices. The resulting footage is then edited to create a five to eight-minute video to document quality improvement opportunities in the voices of patients and caregivers. The video is then distributed across the organization as part of a comprehensive quality improvement process.

The tool allows caregivers to “see nuances that otherwise might be missed, and discrepancies between what people say, what they do, and what they may think,” says Esther Neuwirth, PhD, director of field studies at Kaiser Permanente’s Care Management Institute. “It’s also especially effective at motivating and guiding quality improvement efforts because seeing is believing.”

As of June 2012, nearly 40 Kaiser Permanente teams of more than 130 clinical staff, quality-improvement professionals, and clinical and administrative leaders participated in video ethnography training. Kaiser Permanente has also conducted video ethnography projects in surgical services, breast cancer care, outpatient medication administration, pediatric weight management, care disparities and other clinical areas.

Source: Kaiser Permanente, June 4, 2012   

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