How We Optimized Care and Reduced Hospital Readmissions with Scalable Integrations

Most people have distinct ideas of nursing that involve tending to patients at their bedside—checking vital signs, dressing wounds, or assisting people with daily tasks that they’re too ill or injured to perform themselves. Aside from that, there’s another side of the job that most people don’t see: manually completing charts and assessments, faxing documents to various pharmacies, and losing hours each day trying to get outdated legacy systems to talk to each other.

Nurses often spend time on paperwork that could be much better spent with their patients. That’s why, at Complete Care Management, we eliminated manual workflows to maximize the impact on patients’ lives.

The old approach wasn’t always the best way

Complete Care Management is a rehabilitation provider operating long-term and subacute care facilities in seven US states.  They manage about 90 facilities, including skilled nursing facilities (SNFs) and assisted living facilities (ALFs), and regularly enroll new facilities into the network.  They’re not immune to industry challenges, and fragmented systems, inefficient manual processes, and high hospital readmission rates are always on the radar. 

As their former chief clinical informatics officer, I aimed to provide best-in-class technology to the nurses so they could provide best-in-class care. It’s a clear mission, but being such a widespread organization makes some things easier said than done. Acquisitions make this goal even more complicated because every organization runs somewhat differently, and raising everyone to the same level can be challenging. Not everyone is comfortable using digital-first solutions, either—some people still prefer to handwrite paper reports.

Part of my job was convincing them there are better ways of working. I want all practitioners to have the best tools in their toolkits. That means onboarding them to PointClickCare—a premier product and the best senior care EHR on the market.

Easy integrations simplify daily life

Complete Care Management has used PointClickCare since they opened their doors. So far, adopting nearly all of their solutions, from Integrated Results for Lab and Imaging to risk management software, and also relying on integrations with many third-party tools through the PointClickCare Marketplace.

How many integrations? More than any other organization I know! The list includes Carefeed, Careport Health, GEHRIMED, DocNow EHR, Tapestry Health, and more—and will continue to add integrations through the Marketplace because it’s so easy to use.

There's no need to put out a request for a contract or hire a third-party implementation specialist. With Marketplace, simply request the integration, the vendor approves it, and it’s set up within a few days. I’ve run the numbers: it’s 91% faster for us to use the PointClickCare Marketplace than trying to integrate disparate tools on our own.

Another major benefit of these third-party integrations is staff only have to log into a single platform. The team doesn’t have to switch between tabs and windows or waste time hunting for passwords to log into various systems. It centralizes the data, which simplifies daily workflows and makes standardization easier when acquiring a new property.

We were one of the first organizations to try many of the recent new offerings and integrations from PointClickCare. Anything we felt would benefit our nurses and practitioners is something we were willing to test. This willingness to try new things has led to internal wins and improved patient outcomes.

On-the-floor improvements  

Some of these wins involve adopting a more digital-forward mindset. Practitioner Engagement has been a great tool to help the physicians transition from paper to digital records. We immediately noticed improvements in accuracy and efficiency. Even sticklers for the pencil-and-paper process appreciated that using digital records saves them time and reduces the risk of error compared to keeping physical records.

Nurses feel the time savings, too. PointClickCare’s Integrated Medication Management makes communication easier between facilities and pharmacy partners. This integration allows nurses to reorder meds right from their med cart—no more manually pulling stickers or faxing papers.

Our proudest achievement has been reduced re-hospitalizations. Rather than playing the “blame game” with hospitals over who’s at fault, we improved collaboration by using the PointClickCare hospital transfer portal to provide post-acute and chronic readmission information. This data allows staff to spot trends and share key information with hospital partners. The results have been staggering: we reduced post-acute hospital readmissions from 22% to 9% in just three months.

These results were encouraging to continue expanding the PointClickCare ecosystem and implementing new features and integrations. One example is the work we did to roll out surveys and admission agreements. Utilizing PointClickCare Marketplace to integrate the third-party product into Connected Care Center allows for gathering more feedback and improves the patient experience.

Improving care at every touchpoint

PointClickCare has impacted almost every touchpoint at Complete Care Management, from nurses and residents to hospital and pharmacy partners. By sharing data, we can all work together to solve problems.

I can’t imagine a world without PointClickCare. Trying to use manual paper processes for everything we can do now would be devastating from a time management and error management perspective. PointClickCare is no longer just a tool; we see the team as a genuine partner who has freed us from the hamster wheel of unnecessary, repetitive, manual processes.

PointClickCare has always allowed us to provide better care and better outcomes for patients, and the larger organizations become, the more benefits are experienced. The PointClickCare Marketplace has made existing technology investments efficient, intelligent, and scalable, enabling us to spend more time on what matters—our residents.