Given the Centers for Medicare & Medicaid Services' (CMS) financial penalties for hospitals with above-average readmission rates, many organizations seek ways to prevent 30-day readmissions of patients who undergo percutaneous coronary intervention (PCI), or what's commonly known as angioplasty.
It's not uncommon for anxious patients to end up back in the emergency department (ED) complaining of chest pain, especially if they can't reach their cardiologists. But too often ED physicians almost reflexively admit the patient for a workup, according to an article at TCTMD, which provides online resources in interventional cardiology.
However, there are many ways for hospitals to prevent unnecessary readmissions of heart patients, according to the article. Here are three of the suggestions:
1. Triage of patients who come to the ED with chest pain. Some hospitals have a cardiologist available in the ED. After testing, the cardiologist can make the call as to whether a patient can safely be sent home. As a specialist, a cardiologist may be better able to reassure patients and ED physicians that the symptoms are not angina. Other hospitals notify cardiologists immediately when their patients are in the ED to ensure they get their input before admitting patients.
2. More education for patients following angioplasty. Physicians can help reduce the chance of a return visit to the hospital by educating heart patients about what to expect following the procedure and when to call the doctor's office.
3. Transition of care after discharge. Hospitals should have a plan to proactively meet patients' needs when they leave the hospital, according to the report. Some key areas that need attention include management of medications, especially new drugs, as well as patient education, and family and caregiver engagement. Patients are more likely to understand complicated instructions if they hear them multiple times and can repeat them back to healthcare professionals. Hospitals can identify a 'care partner' to help make sure patients follow their care plans. Nurses or care coordinators can follow up to make sure patients keep appointments scheduled with their cardiologists or primary care doctors.
Hospitals also have had success using telemedicine technology to reduce readmission rates, according to Raymond Hino, president and CEO of the Sonoma West Medical Center in California, in a blog post for Hospital Impact. And electronic health records can also help identify which inpatients are at high risk for readmission.
While much attention is focused on discharge planning, hospital leaders can also help solve the readmissions problem by optimizing patient flow, FierceHealthcare previously reported.
To learn more:
- read the article