Hospital readmission rates are declining and there are several contributing factors. One of the main factors is that reducing patient admissions within 30 days after being discharged from an earlier hospital stay, whether the patient is admitted at the same or a different hospital, or for a different reason, has been a tremendous focus with the implementation of the Hospital Readmission Reduction Program (HRRP). A provision in the Affordable Care Act established the HRRP, which requires the Centers for Medicare and Medicaid Services to reduce payments to Inpatient Prospective Payment System hospitals with excess readmissions in October 2012. Facing penalties and reimbursement reductions, hospitals have taken a proactive approach to ensuring readmissions are minimized.
“Readmission rates will continue to naturally decline as the focus on the patient and the quality of care continues,” says David Chimento, Client Services Manager at Sentact. “In addition, penalties and reimbursement reductions will continue to drive hospitals and health care networks to focus on reducing readmissions.”
Smart Business spoke with Chimento about hospital readmissions and what hospitals are doing to keep readmission rates down.
What are the issues associated with readmissions?
Readmissions are generally associated with congestive heart failure, blood infections (Septicemia), Pneumonia, Pulmonary issues and Cardiac dysrhythmias. These impact individuals of any background and all ages. Most issues that need to be addressed are around recovery instructions, quality of caregiver communications and how well a caregiver responds to a patient’s needs.
How can hospitals lower readmissions? What are some of the proven methods?
Hospitals can lower readmissions through rounding. Here are five top rounds that are proven to reduce hospital readmissions.
- Pre-Admission Rounds: Get a jumpstart on communication with patients during pre-admission rounds. Educate patient on procedures, surgeries, treatments, medications and exercise management before they occur. Rounds such as these have been proven to reduce readmissions by 12 percent.
- Infection Prevention Rounds: Infections account for 1.2 percent of every 1,000 patients readmitted to a hospital. Use rounding to ensure proper hand hygiene, pressure sore management, as well as other infection protocols that reduce infection both during patient stay and after discharge. With better infection control programs and improvement processes, readmission rates decline.
- Employee/Leadership Rounds: Using employee and leadership rounds, hospitals can determine areas that need improvement, such as training and quality. A well-trained staff is better prepared to educate and prepare for a patient discharge. In addition, employee and leadership rounds support a patient-centered care concept where all parties are communicating, ensuring discharge occurs when appropriate.
- Nurse Rounds: It has been proven that nurse presence with hourly rounding throughout the stay prepares patients and educates patients on the discharge process, as well as what to expect after the discharge process. In addition, nurses who complete hourly rounds can identify early warning signs of complications or adverse events that could prevent a discharge.
- Post-Discharge Rounds: Completing discharge rounds, as well as follow-up discharge rounds, ensures patients have a complete understanding of their medication timing, dosage and frequency. It also offers an opportunity to ask questions and have complete clarity — a complete understanding of discharge plans — and receive complete information on post-discharge care.
What do hospitals tend to miss or get wrong as they work to reduce readmissions?
With a true focus on reducing readmissions, hospitals don’t tend to miss much. It is the lack of focus or process improvement that causes readmission rates to increase. Rounding can help hospitals focus on areas that are causing readmission rates to increase. Whether is it communication or quality of care, these areas can be identified and corrected quickly to reduce readmissions.
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