Most days, you can find Joe Alancheril, B.S.N., R.N., out on the unit, talking with family members, patients, medical staff physicians, nurses and community providers. As a care transitions manager on the cardiac stepdown unit at Texas Health Harris Methodist Hospital Hurst-Euless-Bedford, Alancheril is engaged in listening, confirming and reporting to help patients discharge when expected.
As varied as his days are, around 2 p.m., you can find him having the same conversation with a charge nurse. The cardiac stepdown unit at Texas Health HEB began participating in the Talk at 2 pilot in early May.
Talk at 2 is a focused conversation between a charge nurse and care transitions manager about patients who are expected to discharge the next day.
Joe Alancheril, B.S.N., R.N., and Jake Westrup, M.S.N., M.B.A., R.N., CCRN, NE-BC
“We talk for about five minutes about any barriers for the patients we believe will discharge the next day and how we plan to address those barriers,” said Alancheril. “Having a structured time midafternoon, rather than a check-in at the end of the day, gives us the chance to take action that afternoon rather than waiting until the morning of discharge.”
Talk at 2 is one of Texas Health Resources’ strategies for reducing opportunity days, which is a key performance indicator for Texas Health this year. Opportunity days are days a patient stays beyond what is expected for reasons other than medical necessity.
Talk at 2 builds on multidisciplinary rounding, which features a discussion with caregivers about all patients, their expected discharge date and any barriers to discharge.
“Joe and I touch base all day long, but having that structured time around 2 gives us a chance to discuss those patients planning to discharge the next day and whether there have been any unexpected clinical changes since our multidisciplinary rounding earlier in the day,” said Jake Westrup, M.S.N., M.B.A., R.N., CCRN, NE-BC, supervisor, cardiac stepdown unit and central monitoring unit. Westrup often serves as the charge nurse as well.
Talk at 2 also gives Alancheril and Westrup an opportunity to compare information.
“I’ve been surprised to see that the charge nurse and the care transitions manager sometimes get different, pertinent information from different sources,” Westrup said. “Talk at 2 reminds us to share that information with each other.”
Texas Health Hospital Frisco and Texas Health Hospital Rockwall are also participating in the pilot program for Talk at 2.
“We’re seeing in the pilot program how quick and effective Talk at 2 can be in helping us make progress on removing barriers and discharging patients when expected,” said Krista Spiers, M.H.L., R.N., CCM, senior director of care transitions. “The structured discussion supports our enterprise care management work in creating a more efficient and seamless experience for patients.”
Talk at 2 will roll out throughout the system in July.
