How to Decrease Self Discharges and Improve Patient Retention in Your Rehab Therapy Practice

By:  Jennifer Heiligman, PT, MPT

Most of us went into the rehab therapy field to help people.  However, we quickly learned the harsh reality that our chosen profession is also a business.  For a practice to make enough money to keep their doors open, patient visits need to be completed.  One way to promote increased patient volume is to retain your current patients by preventing them from self discharging.  

Some research suggests that 70% of rehab therapy patients will stop coming to therapy before reaching the anticipated end of their plan of care.  This phenomenon negatively impacts the patient’s positive outcome that could be obtained from completing their prescribed plan of care (i.e-allowing us therapists to help them), as well as decreasing the revenue of the practice.  It is said that it can cost up to 5 times more to attract a new patient than to keep a current one.

But, there are some things that can be done to help decrease the percentage of self discharges leading to better patient outcomes, increased patient satisfaction and improved revenue.  We’ve outlines some of the actions that can be taken below.

Build a Rapport with Your Patient

Patient loyalty evolves from relationships being established with their provider.  As the therapist, you need to build the trust of your patient by showing confidence, honesty and by truly listening to them.  After all, the goal of therapy is to help the patient function better, not to show how smart you are.  

One way to help build a rapport with your patient is, when possible, avoid scheduling the patient with multiple therapists throughout their episode of care.  In some practices, this may not be possible.  However, a stronger relationship will be built as the time spent with one specific therapist increases.  This allows the patient and the therapist to get to know each other on a deeper level.  Having a more personal relationship, the patient may not want to disappoint the therapist which may decrease the likelihood of self discharge.  

Help the Patient Feel Invested In Their Recovery

As stated above, the goal of therapy is to return the patient to the highest level of function possible.  When it comes time to establish goals for the episode of care, be sure to make the patient an active participant in the creation of goals.  Ask what is important to the patient and what activities they would like to get back to doing.  If the goal is something the patient wants to accomplish, they will be more likely to regularly attend therapy and take a more active role in performing their home exercise program.

Education is also key.  Take the time to educate the patient on their condition.  Be sure to explain it in terms they can understand and provide educational materials.  Once they understand the impairment, you can then associate how the specific therapy being rendered can improve the condition.  When they have an understanding of exactly how the therapy is helping, they will be more apt to continue with the treatment.

Keep Therapy Interesting and Fresh

If the patient attends multiple therapy sessions and completes the same activities each time, they are not going to see the value in the services you are providing and frankly, they are going to get bored.  To prevent the patient from getting bored and deciding it’s just not worth their time or money, keep the sessions fresh.  Try to mix it up a bit.  When possible, change the order of the activities and continuously add new ones.  This will help the patient realize that their program is individualized and the therapy is valuable.  

The same thing goes for the patient’s home exercise program (HEP).  If possible, provide the HEP in a fun, more interesting manner.   If you are an OptimisPT subscriber, you can use the optimumMe App to send the program to the patient’s smart device.  This allows the patient to access the program electronically from anywhere including pictures and videos. The app also makes it very easy for the therapist to update the HEP often.  In addition, the information flows back into the OptimisPT system for the therapist to review.  Again, if the patient has a good rapport with the therapist, they may not want to disappoint the therapist by not completing their HEP knowing the therapist can see what they are or are not doing.  The more consistent the patient is with their HEP, the better outcome they will have with therapy and the more satisfied and loyal the patient will be to your practice.

Confirm Therapy Sessions Are Scheduled

Before the patient leaves the clinic, be sure that the next therapy session is already scheduled.  Add a check out step within your practice workflow.  This forces the patient to stop at the front desk.  If there are no additional visits on the schedule, be sure to have the patient make appointments prior to leaving the clinic.  It is much harder to try to hunt the patient down after they leave the clinic and if they do not have anything scheduled, they may not feel the obligation to return to therapy.

If a patient does slip out the door before scheduling, take advantage of the reports that are available within your EMR to catch those patients before they fall off the radar.  Within OptimisPT you can run the “Patients Not Seen” report.  This can be run by practice, clinic, or therapist to catch those patients with no future visits scheduled.

Collect and Monitor Patient Feedback in Real Time

Another way to help prevent self discharge is to keep a pulse on how satisfied your patient’s are with their care and your practice, in general.  The Net Promoter Score (NPS) is a well accepted measure for customer satisfaction.  After all, your patients are your “customers”.  

The NPS is a simple, one question survey that measures how satisfied and loyal your patients are.  There is also a section where patients can leave more specific comments, if they wish.  If you are an OptimisPT subscriber, the NPS is available, free of charge, and is sent directly out of the system to your patients at regular intervals.  By monitoring the NPS Report within the system, practice leaders will get real time patient feedback.  This allows for any issues identified to be fixed immediately.  By fixing the issues, patients will feel heard and be more satisfied with your practice.  This, in turn, can decrease the chance they will self discharge and also increase the likelihood of referring your business to their family and friends.  

To learn more about the NPS, please visit our previous blog:  “What is the Net Promoter Score and Why Should I Care?”

Follow Up with the Patient

After the patient is formally discharged from therapy, be sure to follow up with the patient.  This could come in the form of a newsletter that they receive at regular intervals, happy birthday texts or emails, and/or holiday wishes.  The follow up is another method to make the patient feel valued, even after they are no longer attending therapy.  It is also a great way to keep your practice in their mind should they or someone else they know need therapy services in the future.

By implementing the above action items, you will be able to decrease the percentage of absent discharges that occur in your practice.  This will help to accomplish two things.  First, when patients complete their established plan of care they have better outcomes. This makes it more likely we will be able to fulfill our deep seeded therapist goal of helping people.  Second, by keeping visit volume up, we may actually be able to make a living fulfilling our original goal.