The 4 C’s of Reducing Readmissions

Friday, April 15th, 2011
This post was written by Patricia Donovan

Healthcare is using the four C’s — communication, care transitions, case management and collaboration — to reduce readmissions, according to new market research on Reducing Hospital Readmissions.

Our second annual survey on this topic found that across all sectors, healthcare companies are making sure that the information communicated to patients is clearly understood, especially in light of health literacy levels in older patients. Clear communication is never more critical than at discharge from the hospital, when the plan of care and medication instructions are conveyed to patients leaving the hospital.

For example, a seemingly simple intervention — a phone call placed to the newly discharged patient within the first few days — is an opportunity to clarify these instructions and confirm that doctors’ appointments have been made and kept.

Secondly, care transitions, including hospital discharge and transfers between care sites, are being closely scrutinized and improved. Communication again comes into play as organizations make sure that the patient data required to ensure a smooth handoff is included as part of the transfer.

Thirdly, more than a third of respondents assign chief responsibility for reducing readmissions to their case managers.

And lastly, many respondents report increased collaboration and partnerships with community clinics, home health and other providers to improve the quality of care delivery and overall patient experience.

These four strategies are at the heart of patient-centered models such as the medical home and accountable care organizations, and are already driving reimbursement and quality rewards.

On the horizon to further reduce readmissions: increased application of telehealth and home monitoring of chronic illness to intervene at the first sign of functional decline or adverse episode.

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One Response to “The 4 C’s of Reducing Readmissions”

  1. Connie Phillips-Jones RN, MSN, CCM says:

    This cursory review for reducing re-admissions using the concept of the 4 C’s is a good beginning but specifics need to be adressed in detail. What is the evidence associated with succesful communication considering health literacy, patient motivation and cultural competence? What is the evidence associated with case management interventions? What are the minimum qualifications for case managers and what is the standard of practice? How do these minimum qualifications and practice standards “correlate” with evidence and outcomes? And, finally, how does technology fit-in?
    Discussing a conceptual framework using the 4 C’s is a good start but let’s not limit our thinking to platitudes, let’s begin to critically think about theory development.
    Thank you.