Supportive Health Group

Care That Comes To You

Virtual Hospital
Discharge Clinic

Utilizing the latest HIPAA-compliant software, Supportive Health Group providers contact patients within 24-hours of hospital discharge directly on any smartphone, tablet or laptop.

Virtual Hospital Discharge Clinic

Reduce Hospital Readmissions by 30%

Supportive Virtual Discharge Clinic addresses the the 12 Parameters of Hospital Discharge with a team of Nurses, Nurse Practitioners, and Physicians available 24 hours.

12 Parameters of Hospital Discharge

Virtual Discharge Clinic

We can reduce hospital readmissions by 30% by addressing these 12 Parameters of Hospital Discharge. This is accomplished by identifying and correcting the barriers to a safe discharge including patient/family education. When working with Medical Groups and Health Plans, we report our non-biased 3rd party findings so that medical management operations can be refined.

Work Flow

Triage and Referrals

The patient’s condition and needs can be quickly established within 24 hours of hospital discharge via our Virtual Hospital Discharge Clinic. Stable conditions are referred to the Primary Care Physician and Medical Group Case Management for enrollment in corresponding disease management programs. Unstable conditions are immediately assigned for a personal visit by either a nurse or nurse practitioner to avoid re-hospitalization (or ER visits). Our entire team is supported by NPs and MDs that can provide rapid clinical assessment, laboratory testing, radiology imaging, and medication prescriptions (even if the PCP is unavailable).

Special Challenges for a Safe Hospital Discharge

Due to bed limitations at preferred facilities, it is not unusual for a patient to be referred to a non-core, non-contracted aftercare facility such as a Skilled Nursing Facility (including short-term skilled, subacute, and long-term care), Congregate Living Center, Board & Care, Recuperative Care, or Assisted Living Facility.

This patient population already has a high risk of hospital readmission due to multiple co-morbidities and advanced age.

We provide the additional Layer of Protection while increasing patient satisfaction.

SNF and B&C Visits

Special Challenges of SNF and B&C Discharge Locations

  • SNFist may not see patient timely.
  • SNFist visit frequency or availability may not be sufficient.
  • Antibiotic stop dates and other critical information is often missing.
  • POLST / Goals of Care may not be properly established.
  • Highest percentage of hospice and palliative appropriate patients.
  • Many will require long-term placement or increased caregiver hours for a safe home discharge.
  • Variability in care and subsequent risk of readmission may be higher for Board & Care and Assisted Living Facility discharges.

A Supportive Nurse or Nurse Practitioner Can Visit Within 24 Hours of SNF, B&C, or ALF Admission

Goals of Care

Goals of Care and Hospice

Goals of Care are not always established properly during the hospitalization. Or, perhaps, they have changed since the recent discharge – that is, some patients may choose not to return to the hospital and seek non-aggressive, comfort-focused care in their place or residence.

We address all aspects of the POLST in detail with the patient and family. Carefully discussing CPR, intubation, feeding tubes, DPOA selection, and options for care at home without further ER or hospital visits.