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Report: Videotaping Care Reduced Readmissions

June 4, 2012
by Gabriel Perna
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According to a paper produced by the non-profit research consortium Kaiser Permanente Care Management Institute, the use of video ethnography helped contributed to a rapid reduction in hospital readmission rates for elders with heart failure. At the Kaiser Permanente South Bay Medical Center in Southern California, hospital readmission rates dropped from 13.6 percent to 9 percent in six months as a result of a quality-improvement framework that incorporated video ethnography as a care transitions tool for elders with heart failure.

 “Video ethnography is a powerful tool for achieving rapid-cycle improvements in quality that keep the needs of patients front and center,” study lead author Esther Neuwirth, PhD, director of field studies at Kaiser Permanente’s Care Management Institute, said in a statement. “Focusing on the real-time experiences of patients and caregivers allows us to identify care gaps and improvement opportunities and share this knowledge throughout Kaiser Permanente.”

Video ethnography involves video-recording interviews and observations of patients and caregivers in real time to identify care gaps, unmet patient and caregiver needs, and effective practices. According to the study, it was helpful with frail elders, patients nearing the end of life, and those with multiple chronic conditions. These groups, the authors say, are typically not well represented in other quality improvement approaches.

According to Kaiser Permanente, the process involves video-recording patients and caregivers as they are being interviewed and observed interacting with each other in a clinic or hospital or at home. Recurrent themes are reviewed, including patient and caregiver needs and choices, care gaps, and effective practices to determine quality improvement priorities. The resulting footage is edited to create a five-to-eight minute video to document quality improvement opportunities in the voices of patients and caregivers.

“Video ethnography allows us to see nuances that otherwise might be missed — discrepancies between what people say, what they do, and what they may think,” Neuwirth said. “It’s also especially effective at motivating and guiding quality improvement efforts because seeing is believing.”

The research will be published in the June issue of Health Affairs,

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