Successful strategies to cut patient readmissions
Wednesday, June 27, 2018
As a hospital administrator, there's no doubt that you're seeking to avoid readmissions in any way you can. You want your patients to do well health-wise after discharge, first and foremost, and you also want to avoid any financial penalty from Medicare for especially high readmission rates at your institution.
This can be hard to accomplish, however; a study from Vanderbilt University and the Veterans Administration found that 19.6 percent of Medicare patients were rehospitalized within 30 days of discharge, and 34 percent of Medicare patients within 90 days.
The good news? There are concrete steps you can take to reduce this issue, improve your patients' outcomes, and strengthen your staff members' collaborative efforts as they work to make the post-care transition as safe and seamless as possible. Here are five essential points to put into practice:
Work with effective home healthcare agencies.
Researchers from the University of Pennsylvania found that home healthcare nurses are often burdened with so many administrative tasks that their focus on actual patient care is unnecessarily limited. This is obviously risky for the newly discharged.
If you have a home healthcare program incorporated into your organization, coordinate with its managers on how time-consuming duties like filling out admissions documentation can be rerouted back to the office. If you're evaluating an outside agency to work with, ask its managers for in-depth detail as to how they delegate this kind of work, and don't contract with an organization that isn't willing to give nurses ample time to perform quality care.
Involve your patients' families in their care early on.
An innovative program at Intermountain Medical Center in Murray, Utah, provided training to family members of patients before they left the hospital, through detailed instructions on skilled nursing procedures.
The result: the 30 day readmission rate for these patients was 65 eprcent lower than it was for patients whose loved ones didn't take part in the training.
Not only does teaching proper procedural care help spouses and children work in tandem as a second set of hands for a home nursing team, it builds a sense of emotional purpose and confidence in those family members as they know they are directly helping their loved one recover.
Improve your doctors' communication with the home healthcare team.
Researchers from the University of Colorado have reported that there are often wide communication gaps between hospitalists and home health care aides that can often directly impact rehospitalization.
For example, home health aides often don't have access to patients' electronic medical records or up-to-date medication lists, and don't have simple phone access to the doctor in charge of this vital information.
Set up a system in which your hospitalists speak about these matters with the agency manager or aide before patient discharge. Also, make sure your doctor’s contact information is available to the agency and aide, and require the doctor to return calls or emails to the aide promptly post-discharge, if necessary.
Make sure PCPs are fully informed.
Many times, PCPs don't even know when their patients are hospitalized, even though their efforts are crucial to successful post-discharge care.
Ensure a member of each patient's care team — doctor, resident or nurse — contact PCPs as a rule as part of the discharge process to inform them of that patient's medical status, and to confirm the fact that the PCP will see the patient for follow-up within seven days.
Let your patients be your guide.
Your staff should directly ask patients about any discomfort they have before they leave the hospital. This step would appear to be a no-brainer, but is often skipped due on a busy day.
Make sure your staff always invests the time in a simple, honest conversation, as the information they receive back will guarantee that a patient isn't feeling too sick to be released just yet.
This type of talk will also allow patients to discuss any questions or concerns they have about discharge instructions, medications or diet. Everything can be carefully explained so every patient feels completely reassured -- and stays well.
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