Hospitals Devise Strategies to Tackle 30-Day Readmissions (Part 2 of 4)

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RA-thumb3In our last post, we looked at how some hospitals are focused exclusively on reducing 30-day readmissions on those diseases that are currently penalized—heart failure, pneumonia, heart attack—while others are taking the all-cause readmissions approach that the government is expected to adopt eventually.

As Cheryl Clark writes in the May 2013 issue of HealthLeaders magazine, “Integrated systems are working with their physician networks to make sure there’s a provider ready to ‘catch’ these patients after they’re discharged to give them what they need so they don’t come back.” Furthermore, specialty care coordinators and transition coaches are being added to hospital care teams and partnering with skilled nursing facilities and community home-health agencies to reduce 30-day readmissions.

“In some cases, programs track patients for as long as 60 and 90 days, not just because it’s good for the patient: Some hospitals say it’s good for their bottom lines, especially when the readmitted patient is uninsured or underinsured,” Clark adds.

Lee Ann Liska, chief operating officer for Ohio’s Mercy Health, told Clark, “If you have a vulnerable population struggling with chronic disease, multiple illnesses, and challenges like socioeconomic issues, poor living conditions, poverty, illiteracy, as a mission-based organization we believe if we invest in the front end we’ll save on the back end by avoiding unnecessary readmissions.”

Zeev Neuwirth, M.D., chief medical officer and senior vice president of ambulatory care and corporate services for Carolinas HealthCare System, explained, “In an effort to reduce inappropriate readmissions, our hospitalists and ambulatory physicians are meeting together to create solutions that provide more seamless coordination of care during the transition from hospital to home. We are piloting numerous innovative initiatives involving technology, which include using iPads to communicate with patients at home and evaluate the safety and healthfulness of homes, and home biometric monitors to track patients on a daily basis.”

The impact these efforts have had on its Blue Ridge HealthCare network in Morgantown, N.C., have been profound, with readmission rates for COPD drastically declining from 12.56 percent in 2011 to 11.59 percent in 2012. For all-cause readmissions, Blue Ridge’s Grace Hospital, also in Morgantown, expected an all-cause readmissions rate of 10.13 percent in 2012, but only saw 6.35 percent.

In our next post, we’ll take a look at another healthcare organization that has also experienced terrific results by focusing on all-cause readmissions.

In the meantime, what approaches do you use to unite your care team around reducing hospital readmissions? What strategy has been most effective?

-by Pete Fernbaugh

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