Radically Reduce Readmissions

Posted: Fri, Sep 5, 2014 07:38

Let’s take a look at some readmission facts – but I warn you, they’re not pleasant. One survey showed that only 41% of patients knew their diagnosis when they went home, only 37% were able to state the purpose of their medication, and just 14% knew the common side effects of their medications.

We have to do better, because a caring discharge matters.

Consider This:

There are seven reasons why poorly managed discharges matter:

• possibility of pain and suffering (lack of proper strategies for life after the hospital)
•  needless stress put on a family (perhaps unprepared to manage home care)
• extra costs (a family member might have to take time off work)
• patient and family dissatisfaction (they may feel lost, or abandoned by the hospital)
• financial repercussions for poor performance (HCAHPS, VBP)
• reputation in the community may be effected
• unnecessary readmissions

“It’s not the readmissions,” says a hospital administrator, “it’s the avoidable readmissions.” We don’t want people to need hospitalization and they don’t want to be hospitalized, so let’s make sure they have what they need to get better and go home.

I’m sure most readers of this blog know the two questions in the HCAHPS Survey that regard discharge (specifically related to help at home and written counselling), but to review:

1. During this hospital stay, did doctors, nurses, and other staff talk to you about whether you’d have the help you need at home?

In other words, do we, as caregivers, feel assured that our patient is prepared to manage his or her care with appropriate help at home?

2. During this hospital stay, did you get information in writing about what symptoms or health problems to look for after you left the hospital?

So, did caregivers provide written information and counselling given to the patient and family about future symptoms or challenges?

Poorly managed discharges matter because poor outcomes mean longer recovery time, or unnecessarily readmitted patients. Statistically, this effects one of every five patients within three weeks, which costs twenty-six million dollars every year. 76% of readmissions are avoidable.

Why not create your own team (or unit) based mission statement based on your team’s shared goals and values? Good examples of a team mission statement are:

• We are going to provide a safe discharge every time
• No adverse events
• Excellence in recovery at home, or
• We empower self-reliance in every patient

The concept of the mission statement is just to have clarity about what you want to accomplish during this process.

The Take Away:

“How patients leave is as important as how they came in.” Says Stella Fitzgibbons, a hospitalist in Houston TX. We remember most what we experience last – so let’s make sure that our patients have something good to remember.

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