"The cost of readmissions to the healthcare system is substantial, accounting for an estimated $17.4 billion in spending annually by Medicare alone." -Reducing Hospital Readmission: Current Strategies and Future Directions
Being a hospital administrator comes with endless challenges.
Regarding hospital readmissions, there are two main considerations: patient satisfaction and financial stability.
This article will cover clear steps to take to create your strategy to reduce hospital readmissions and, ultimately, the cost of it for your facility, budget, and reputation.
How to Reduce Readmission Rates?
The following are nine specific measures your facility and staff can take to reduce those readmission rates and increase patient satisfaction.
1. Understand the Policies
The Hospital Readmission Reduction Program (HRRP) is a foundation of the Affordable Care Act (ACA) to reduce the number of patients readmitted to hospitals shortly after discharge using the Medicare 30-day readmission rule.
What is the Medicare 30-day reaådmission rule? This HRRP rule penalizes hospitals with higher than expected 30-day readmission rates for specific medical conditions.
"Excess readmissions are measured by a ratio, calculated by dividing a hospital's predicted rate of readmissions for heart attack (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), hip/knee replacement (THA/TKA), and coronary artery bypass graft surgery (CABG) by the expected rate of readmissions, based on an average hospital with similar patients." -Centers for Medicare & Medicaid Services
Hospitals that have excessive readmission rates for conditions like heart failure, pneumonia, and heart attacks may face reduced reimbursement from Medicare, the federal health insurance program for people aged 65 and older.
The HRRP program was born to encourage hospitals to focus on improving the quality of care to prevent unnecessary readmissions, ultimately reducing healthcare costs and improving patient outcomes.
2. Balanced Nurse-to-Patient Ratios
Nurses are significant in patient care, education, and care transition in healthcare settings. Therefore, a balanced ratio of nurses to patients is crucial for reducing hospital readmissions because it impacts patient care quality and outcomes.
Adequate staffing levels allow nurses to provide personalized attention, timely interventions, and complete discharge planning, essential for preventing complications, ensuring medication adherence, and addressing patient needs post-discharge.
Nursa can help enhance the quality of care, improve patient satisfaction, and ultimately reduce the likelihood of readmissions by fostering a supportive and attentive care environment.
3. Identification of High-Risk Patients
Recognizing characteristics and circumstances that predispose patients to readmission is crucial. Factors such as specific medical conditions, comorbidities, emotional and personal issues, age, medication management, and support systems play a role in determining the likelihood of readmission.
Facilities can use validated risk assessment tools or predictive models to stratify patients based on their risk of readmission. This approach also helps consider clinical criteria and indicators associated with increased risk of readmission, such as specific medical conditions, recent hospitalizations or emergency department visits, complex care needs, polypharmacy, cognitive impairment, and inadequate social support.
The targeted effort of identifying high-risk patients can improve patient outcomes, enhance healthcare delivery efficiency, and reduce hospital readmission costs through prevention.
4. Point of Care Charting
As many patients are treated by several doctors and clinicians, documenting the details of the patient medical chart, like recording observations, assessments, interventions, and outcomes in real-time, ensures accurate and up-to-date documentation of patient encounters.
The documentation of these charts is usually put in place by the nursing staff as part of their shift routine.
This detailed approach can avoid human error mistakes in each patient's medical care during shift or practitioner changes.
5. Transition of Care Models
One of the most straightforward strategies to set in place is the transition of care model. These medical communication tools models encompass broader frameworks and interventions to improve care transitions and reduce hospital readmissions. It often involves multidisciplinary teams, standardized processes, patient education, and follow-up procedures to support patients during transitions between care settings.
There are several Transition of Care models available, such as:
- BOOST - Better Outcomes for Older Adults through Safe Transitions
- GRACE - Geriatric Resources for Assessment
- TCM - Transitional Care Model
- Project RED - Re-Engineered Discharge
- Bridge Model
- Care of Elders
- Guided Care
- STAAR - State Action on Avoidable Rehospitalizations
Plus, providing good communication and allowing questions from the nurse to take over helps to avoid mistakes and blind points. It even saves your facility from any caregiving delay stemming from cyber attacks.
6. Patient Education
Before a patient is discharged from the hospital, before the staff starts getting the hospital discharge papers ready, a detailed orientation about the self-care they need to provide for themselves back home will become an essential factor in their recuperating fully or becoming another number in the readmission data.
The discharge instructions should include diet and movement requirements—as well as restrictions— and, most importantly, the correct consumption of the prescribed medication, contemplating that the latter won't conflict with the drug administered to the patient during their hospital stay.
Patient education and engagement help patients become active participants in their care process, leading to lower readmission rates and decreasing the cost of care.
7. Medication Reconciliation
Medication reconciliation can help identify and resolve discrepancies to ensure safe and effective medication use across care transitions, such as hospital admission, transfer, and discharge.
The staff can use any of the transition of care models to do this monitoring, for comparing a patient's medication orders to what they have been taking can reduce readmission rates by ensuring proper medication management post-discharge. Be sure to check in the facility in which you are working for specific protocols.
8. Patient Follow-up Interviews
Once a patient has the hospital discharge and goes back home, there are different time windows in which their bodies can present signals of either recovery or alarms that could indicate a need for a medication change or a simple check-up that can prevent a case of readmission.
The benefits of using this method—especially with high-risk patients—go from increased medication adherence, early identification of complications, tailored support, and adequate resources for each case.
9. Healthcare-Acquired Infections (HAIs)
Preventing healthcare-acquired infections is important for reducing the rates of hospital readmission. Key measures include promoting hand hygiene among healthcare workers and patients, implementing infection control precautions (e.g., use of personal protective equipment, isolation precautions), maintaining environmental cleanliness, and optimizing antimicrobial use to prevent antibiotic resistance.
Using evidence-based infection prevention practices, healthcare facilities can minimize the risk of HAIs, protect patients and healthcare workers, and improve overall healthcare outcomes.
Prevention Is Key
As we see in every one of the strategies presented in this article, the more your facility encourages techniques, models, and overall prevention measures, the more successful it will be in lowering its hospital readmission rate.
Prevention asks for the right staff, not just in numbers but in quality. If you want to improve your health center's quality of care, register with Nursa now and find PRN nurses near you.
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