Preventable readmissions to the hospital within 30 days of discharge has been one of the most talked-about metrics in patient care the past few years, and it is a centerpiece for savings and quality improvement under the Affordable Care Act. Hospitals that five years ago likely paid little attention to their readmission rates can today quote multiple versions of their rates and what they are doing to lower it.
While we have historically paid attention to preventable readmissions at New Hanover Regional Medical Center, we certainly are in the category of those hospitals that today are very attuned to their 30-day readmission rate. The Affordable Care Act penalizes hospitals with rates the government says are too high. That penalty can be as much as 3 percent of a hospital’s Medicare inpatient revenue, or several hundred thousand dollars in our case. I am proud to say that we are among the 20 percent of hospitals in North Carolina that have not been penalized so far.
For the past two years, two of our patient care units have been part of a pilot project, led by the N.C. Quality Center, to reduce readmissions, and we found that some relatively simple interventions can have a profound impact. We believe we can transfer these lessons to the entire hospital and become an industry leader in this field.
And now we have a partner who believes in us as well. The Duke Endowment, a private foundation in Charlotte that strengthens communities in North Carolina and South Carolina, has generously awarded NHRMC a two-year, $900,000 grant to expand what we’ve learned throughout the hospital. Our goal is to develop “standard work” on successful tactics that prevent readmissions, then share those with other hospitals and providers.
The primary thrust behind reducing readmissions has been to save health care costs, as the average hospital admission costs Medicare about $10,000. Many of these readmissions could have been prevented with better education, better medication management, better follow-up at home, or better connection to available community services.
But beyond saving money for the government, the best reason to prevent readmissions is because it’s best for the patient. Hospital stays are often difficult for already-vulnerable patients, as their eating and sleeping rhythms are disrupted, and they are often medicated, disoriented or anxious. Our goal is to get patients well – and have them stay well in the comfort of their homes.
With our pilot program, we quickly realized we needed to identify which patients are most likely to readmit and design our interventions for them. We developed a quick assessment to identify “high-risk” patients, basically those who have multiple disease states, multiple medications, multiple admissions to the hospital and – the most accurate readmission predictor – little to no social support at home. We directed these interventions to those “high-risk”patients:
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