"With video, you capture the whole process; how people are doing things. We know that what people say they do and what they actually do are sometimes different," Neuwirth says.
In one project involving a deep dive into 600 cases of patients who had a 30-day readmission across 20 Northern California hospitals, "potentially preventable cases” each contained an average of 6.6 missed opportunities to prevent a readmission, according to a slide presentation by Paul Feigenbaum, MD, Kaiser's Northern California Medical Director of Hospital and Continuing Care Programs.
Neuwirth, Feigenbaum and the team have developed presentations, videos of patients and caregivers for internal quality improvement, as well as a tool kit with a step-by-step guide for other hospitals and health plans that wish to use video ethnography for change.
Providers who reviewed the case studies of the 600 patients concluded that 55 of their readmissions, or 11%, were "very or completely preventable" according to one of Feigenbaum's slides, and an additional 36% were slightly or moderately preventable. That's a lot of potentially avoidable, not to mention costly care.
They realized that far too many patients don't understand why they're taking medications, or think they may be taking too many. "Some store all their, new and old prescriptions in shoeboxes to organize how they take their medications," Neuwirth says. Concurrent medication reconciliation with a home health nurse, a pharmacist, and the patient was one solution that led better medication management.