Tackling Readmissions: An Introduction

This is the first in a series of posts about readmissions.

High readmission rates not only affect a facility’s reputation but can also impact the bottom line. In 2015, 78% of acute care hospitals were assessed a penalty for poor readmission rates. This amounted to over $428 million dollars in avoidable fees.

Of the $26 billion Medicare paid in 2013 due to readmissions, it’s estimated that $17 billion was from potentially avoidable readmissions.  Concentrating efforts on lowering preventable readmissions presents facilities with the opportunity to not only reduce fines but to help provide long term, sustainable care to their patients.

Reasons for Preventable Readmissions

According to the Center for Healthcare Quality and Payment Reform, the causes of preventable readmissions can be categorized into three areas:

  • Complication or infection from the previous hospital stay
  • Poor/unclear discharge instructions
  • Recurrence of the chronic condition that led to the hospitalization

Hospitals looking to control readmissions are focusing their efforts on the first two areas, where they can have the most impact, and readmissions tend to occur within 30 days after discharge.

Reducing Readmissions

As hospitals continue to suffer financial penalties due to readmissions, administrators have been thinking “out of the box” to find ways to reduce the number of avoidable readmissions. One method that has proven successful is implementing programs that extend patient care beyond the four walls of the hospital. These programs allow for:

  • Increased follow-up care
  • Better medication management
  • Improved communication among care teams
  • Continuous monitoring of patients

In order to make these programs successful, members of the care team need to work together to ensure patients have the tools and support to move forward with their recovery.

Working Together to Make a Difference

Both nurses and pharmacists play prominent roles in effective post discharge programs by increasing follow-up care and managing a patient’s medication. In addition, hospital administrators are stepping in to pilot new technologies to facilitate communication among care teams and keep tabs on patients. Through this technology, the team can discover potential issues before they become serious health threats.

Reducing readmission rates is in everyone’s best interests. In future posts we will look at how nurses, pharmacists and hospital administrators are changing the way they work in order to reduce preventable readmissions.  By implementing smarter processes and new technologies, everyone benefits—especially patients who will receive higher quality care and make fewer return visits to the hospital.

Related article:

Kaiser Health News

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