Posts Tagged ‘hosptial readmissions’

Infographic: Coded Severity and Readmission Reduction

December 27th, 2017 by Melanie Matthews

A federal program that has been shown to reduce hospital readmissions may not have been as successful as it appears, according to a new infographic based on a study by University of Michigan researchers.

The infographic examines how the reduction in patients heading back to the hospital could be attributed to how the diagnoses were coded.

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics
Concerned about escalating hospital readmissions from skilled nursing facilities (SNFs) and the accompanying pinch of Medicare readmissions penalties, three Michigan healthcare organizations set competition aside to collaborate and reduce rehospitalizations from SNFs.

To solidify their coordinated approach, Henry Ford Health System (HFHS), the Detroit Medical Center and St. John’s Providence Health System formed the Tri-County SNF Collaborative with support from the Michigan Quality Improvement Organization (MPRO).

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics examines the evolution of the Tri-County SNF Collaborative, as well as the set of clinical and quality targets and metrics with which it operates.

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Patient Handovers, Recorded Discharge Instructions Key to Improved Care Transitions

May 8th, 2013 by Patricia Donovan

recorded discharge instructions

Webinar Replay: Care Transition Strategies for Effective Patient Handoffs

For two healthcare organizations, care transitions began to improve when they focused less on readmissions data and more on their patients.

Retooled patient handovers — a subtle but significant shift in terminology from ‘patient handoff’ — and recorded discharge instructions were two strategies for managing care transitions, an area key to reducing readmissions and healthcare costs, and improving patient care and satisfaction.

During Care Transition Management: Strategies for Effective Patient Handoffs, a 60-minute HIN webinar on April 24th, now available for replay, Joshua Brewster, director of care management at Regions Hospital, a HealthPartners hospital, and Cheryl Bailey, vice president of patient care services at Cullman Regional Medical Center, shared these strategies and more, all of which have led to impressive results.

By focusing on the patient and the handoff process, Minnesota’s Regions Hospital has watched its readmission rates decrease from over 11 percent in 2009 to 9.5 percent for all patients and achieve readmission rates for 2012 that are better than its expected results, as predicted by modeling outside of the organization, says Brewster.

And Cullman Regional Medical Center’s award-winning “Good to Go” recorded hospital discharge resulted in a 15 percent decline in readmission rates for patients who received recorded discharge instructions and a 62 percent increase in HCAPS satisfaction scores.

For both Brewster and Bailey, their strategies began by paying attention to the patient. “We noticed our patients weren’t listening to their discharge instructions, and their caregivers were being left in the dark,” says Bailey. So began the seed for CRMC’s award-winning “Good to Go” program, where nurses began recording their patients’ discharge instructions. One of five winners of the Robert Wood Johnson Foundation’s Transitions to Better Care video contest, the idea was simple but effective: when patients were about to leave the hospital, their nurse would inform them that they were going to record their discharge instructions, and would share them afterwards via the phone and computer.

The benefits of the program were wide ranging, Bailey continues. Realizing the notes were being recorded enabled the patients to relax, and allowed better comprehension and compliance. Good to Go “extends the relationship between the nurse and patient beyond the walls of the hospital,” Bailey says.

In terms of technology, there was a 40/60 split between Web site and phone access; with 30 percent of the instructions accessed more than once, and more than 40 percent retrieval of instructions when notifications were sent to patients and families.

And internal analysis of the recorded discharge instructions helped CRMC to further refine its discharge process and identify patients in need of post-discharge support.

For Regions Hospital, micro-managing their patients was key to their decrease in readmission rates: in 2012, more than 380 readmissions were avoided, Brewster says.

Similarly to CRMC, Regions noticed that their patients might say they understood their medication instructions, but they didn’t. By establishing a process called Medication Boot Camp, they not only showed their parents and caregivers what to do, but sent them home with instructions and any necessary tools, i.e. numbered pill boxes.

They sought out small grants for lower income patients who would benefit from home care but couldn’t afford it, and even changed the wording of ‘patient handoffs’ to ‘handovers.’

They wanted to make sure that they weren’t turning patients off, but over to another facility/environment, but would still maintain communication and information, Brewster said.

But the most important change for Regions was establishing a Transitions in Care Committee, Brewster says.

“For a long time it was the ‘readmissions work group’, but we wanted to move away from the idea that all we are doing is preventing readmissions. What we are really trying to do is improve transitions as patients move from one care setting to the next. That’s not always just moving from the acute care setting or the hospital, back out into the community, but also those coming into the hospital. Because we think there is a lot that we can learn about patients and do to prevent readmissions before the patients even get to the hospital.”