Follow-Up Calls Ease the Road to Recovery

Massena Memorial Hospital’s number one priority is the delivery of quality patient care. As part of the continuity of care the hospital has implemented a Community Outreach program.   When someone is an inpatient, their main goal is to go home. Each patient is given discharge instructions, but sometimes the message is forgotten because they are in a hurry to go home.

Karen Wilkins, RN, BA, Director of Community Outreach calls every inpatient that has been discharged to follow up and ensure the patient is doing well. She reads each inpatient medical record and reviews the physician discharge summary and the nurse’s discharge instructions for the patient. She then calls the patient to make sure they understand their medicine, follow a special diet or if they need any additional help.

Many times she will offer education to the patient on watching for signs of infection, when to contact your physician, reinforcing the importance of following a new diet. “During these calls, I have had many people who asked me to pass on their appreciation-for the smiles, the courteous care, the good food, and just for making them better,” said Wilkins. “I ask the patient how their care was and offer them an opportunity to discuss any concerns or compliments of the care delivered. I try to keep them as empowered as possible, but to be an additional resource from MMH.”

“Karen is tasked with calling every inpatient that is discharged to their home as a follow up for continuity of care. Whether the patient was in the ICU or maternity they will be called, which may equate to 50-60 calls a week,” said Sue Beaulieu, RN, MSN, FACHE, Nursing Executive Director. “She tries to speak with each patient to ensure they follow up with scheduled appointments or testing, or if they are following the appropriate instructions whether it be a change in their medication or if their pain is being tolerated. The program is a great community service to make sure our patients are on the right road to recovery.”

“As I call the patients shortly after their discharge to see how they have been doing, I have received very positive results and comments. I thank them for allowing us to take care of them and to help them get better is my first goal. On behalf of all of us, our patients need to know that,” Wilkins said. “This program is working well. I get a lot of positive comments about the care they received at MMH, and many questions. Sometimes I will send a referral to other departments to follow up such as Dietary, Financial Counseling, Registration, their physician or an outside agency like Public Health.”

As the positive reception from the patients with the Community Outreach, Wilkins has identified the continued need for community health and medical education.  The fascinating and every-changing field of healthcare offers a wealth of learning possibilities for groups of all ages. Because of the public’s increasing desire to know more about healthcare, Massena Memorial Hospital provides a speaker’s bureau through the Community Outreach Education and Community Relations for community organizations, service groups, area schools and church groups.

For years the hospital offers monthly community seminars on a variety of healthcare topics presented by the physicians and hospital health care team. Now Wilkins would like to bring some of the education to the community groups as mentioned.  The goal of the Community Outreach is to help people better manage themselves with Coronary Heart Failure, High Blood Pressure, Diabetes, Advance Directives, or the Flu.

Wilkins hopes that by providing education the community has identified as a need; increased awareness will improve not only the individual’s health but the community’s health too.  “We have to change with the philosophy of healthcare. Patients want the facts to be more proactive in their care today.”

If anyone wants to arrange for a presentation they can call the Community Outreach Office at 315-769-4345. Presentations and talks need to be scheduled with at least four weeks’ notice.


October 2015

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