One Arkansas hospital system has cut readmissions nearly 90 percent by addressing both direct and indirect contributing factors, according to Executive Insight.
In seeking to address readmissions, the majority of hospital leaders concentrate on an internal approach, using methods such as follow-up calls to patients after discharge, writes Labray Merkel, health coordinator at CHI St. Vincent's Hospital. However, this approach is inherently limited, she writes, because they don't provide the opportunity for patient-centered, personalized care, an essential feature of the modern healthcare landscape, and therefore don't address the underlying causes of readmissions.
Indeed, research indicates some of the top drivers for readmissions are factors such as employment status and high school education. Many hospital advocacy groups have protested that the outsize effect of sociodemographic factors on readmissions makes it inappropriate to penalize hospitals based on their rates.
Seeking to fix these problems, CHI St. Vincent's recently fine-tuned its protocols for pre-surgical patient contact and post-surgical follow-up, Merkel writes. For example, the hospital implemented pre- and postsurgical follow-up calls within 24-hour, 48-hour, 10-day, 30-day, 90-day and 120-day windows. It also improved workflow by allowing patient-centered monitoring of individual patients' care process inside and outside the hospital. This allowed hospital staff to discover any potential barriers to care outside the healthcare setting, such as transportation gaps, lack of social support or financial obstacles.
Since implementing these protocols, Merkel writes, CHI St. Vincent's readmission rate has fallen from 24 percent to under 4 percent, due largely to the heightened scrutiny of individual patients' processes of care. This success, she writes, demonstrates that meaningful solutions go beyond the physical confines of hospital facilities.
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