5 Steps to Reduce 30-Day Readmissions for Heart Attack, Heart Failure and Pneumonia

Wednesday, August 3rd, 2011
This post was written by Patricia Donovan

How to reduce rehospitalizations for the “big 3” to improve core measure ratings? “Hit them hard and hit them big time,” says Dr. Steve Berkowitz, president at SMB Health Consulting and former chief medical officer for the central and west Texas division of HCA at St. David’s HealthCare.

Dr. Berkowitz shared five of St. David’s strategies for reducing 30-day readmissions during the Q&A of a recent webinar on Healthcare Performance Improvement: Exceeding Core Measure Targets for Value-Based Reimbursement.

“We have seen in our pilots enormous improvement in rehospitalization rates. We were cruising along before our program at about 18 to 20 percent on heart failure and pneumonia, which is around the national average. Our pilots have gotten it down to 2 or 3 percent. So, there is no question that we can do this. We can hit it hard and we can hit it big time.

“What it really amounts to is the whole idea of the continuity of care. The patient goes to a nursing home. Make sure that the nursing home gets the medications. Make sure that there is good communication between the physicians. Make sure that patient is getting daily weights and all the things that they need to do this. If the patient is going home, provide individual patient education. Establish good communication with the attending physician. All these steps have dramatically reduced readmissions.”

There is a flip side, however:

“I’ll tell you where the rub is right now. though. Presently, readmissions generate a lot of revenue so that our hospital administration wants us to reduce them. But maybe not to reduce them too much, and maybe to not reduce them too fast. That is one of our challenges.”

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