Trust, coordination among staff and speedy processes are essential to hospice referral management.

This is according to new research from Transcend Strategy Group. For the consulting firm’s most recent Insights Report it conducted in-depth interviews with hospice admissions and business development professionals to identify recurring themes, barriers and opportunities.

“In most competitive markets nowadays, responding to referral sources immediately is the expectation, but also getting to the patient’s bedside in an hour, in some cases, is the expectation of referral sources,” Courtney Penn, COO for Transcend Strategy Group, told Hospice News. “If a hospice is not going to be able to deliver on that, then there is a competitor waiting in the wings to do that, probably waiting in the waiting room of the hospital”

Speed is a top priority for referral partners and patients when it comes to admissions. To be successful, hospices must admit patients within a matter of hours at the latest, according to the report.

However, this must be blended with empathy and sensitivity for what families are going through, the report said. An empathic approach can help hospices mitigate families’ fears about coming to hospice, which often represents a barrier to care.

“We have to remember that for the person calling this is probably one of the worst days of their life — if it’s a family member, or if they’re calling on behalf of themselves — and they need help urgently,” Tony Kudner, chief strategy officer for Transcend Strategy Group, told Hospice News. “So we have to get the details we need to get for a complete and compliant admission underneath the guidelines, the regulations around what CMS requires, but also capture their full humanity so that we can sort of set them up for success and act with urgency.”

Poor alignment between admissions and clinical teams can lead to delays in care. Also, unless they are communicating effectively, sometimes sales teams can make promises that clinical teams can’t deliver, creating frustration for patients and families, according to Transcend. This could lead patients and referral partners to look elsewhere.

Essential action items for leaders include the establishment of clear roles for all staff involved in the admissions process, as well as a means of holding them accountable for their performance, the report indicated. This involved fostering trust among those professionals, regular meetings and communication between clinical and business development teams, staff training and development of further collaborative opportunities for those stakeholders.

“There are two siloed departments and the two often do not meet in a way that fosters collaboration,” Penn said. “So by getting those two sets of team members on board to understand the patient journey, understand where the hiccups are, and understand that, together, if they adopt that collective mindset of urgency, that they’re helping one another, they’re helping themselves, and most importantly, they’re helping the patient. Then, by extension, they are helping the referral source to have a good, consistent, predictable, high quality experience.”

Key strategies for streamlining admissions processes while remaining effective include establishing a goal for time between referral and the beside and share that with all employees. Leaders should also ensure that triage and case management nurses are training to step in and complete admissions quickly during times of high-referral volume.

Providers can also leverage technology in these efforts, such as digital scheduling tools and digital patient documentation solutions to support compliance, quality and efficiency, the report indicated. They can use predictive analytics to anticipate spikes in referrals and plan for staffing accordingly.

Other key elements may seem tangential to admissions but are nevertheless critical. This includes having sufficient staff to carry out these tasks efficiently, the report said. Providers can build a pipeline of potential new hires before open positions become available. They can also partner with local educational institutions to give nursing, social work and medical students exposure to hospice and palliative care, perhaps leading them to pursue a career in the field.

Also important is community education about the nature of hospice care and the services that providers offer to patients and families, according to Transcend.

“Having a set cadence of purposeful meetings is honestly the way that collaboration starts. You can’t email a set of directives and expect monumental change,” Kudner said. “It doesn’t happen through whispering down the lane. It really does take the investment of time and intentional agenda and maintaining focus on the purpose of it to eventually get teams to adopt the change that’s necessary to improve.”