Hospital-community collaboration reduced readmissions by 4,570

A collaborative initiative involving 83 hospitals and 93 community partners in Minnesota saw 4,570 fewer avoidable hospital readmissions between Jan. 1, 2011, and Dec. 31, 2012, saving more than $40 million.

Avoidable readmissions in the fourth quarter of 2012 dropped about 17 percent from the baseline, according to an announcement from the RARE (Reducing Avoidable Readmissions Effectively) Campaign.

Participating hospitals and providers used a combination of comprehensive discharge planning, medication management, patient engagement, transition care support, and transition communications.

"We're challenging ourselves to think beyond the ­hospital system and beyond a focus on disease-specific efforts," Minnesota Hospital Association President and CEO Lawrence Massa said yesterday in the announcement. "Hospitals are taking specific steps to ensure a culture that is supportive of collaboration and that supports this readmissions work."

Swift County-Benson Hospital used patient education, increased communication with primary care providers and improved patient transfer communication with local agencies and nursing homes.

Similarly, after Windom Hospital updated discharge instructions and engaged nursing homes and home health agencies, its avoidable readmission rate fell from 0.85 in 2009 to at or near zero for multiple quarters in 2012, according to the campaign's May report.

While communication plays a big role in discharging, transitioning and engaging patients, poor communication between inpatient and outpatient healthcare providers doesn't necessarily cause more readmissions. The April JAMA Internal Medicine study suggested efforts to improve provider communication at hospital discharge may not, alone, prevent readmissions, FierceHealthcare previously reported.

To learn more:
- here's the announcement
- check out the RARE report (.pdf)

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