Nurses at California Hospital Medical Center in Los Angeles took matters into their own hands when it came to trying to reduce 30-day readmissions.
A nurse committee developed a form that nurses fill out when patients are admitted to the med/surgical unit--the unit with the highest readmission rates--to determine which patients are at high risk for readmission, Nurse.com reported. They assess mobility, risk of falls, oxygen use, age and other factors as part of the questionnaire. A case manager reviews cases for patients identified through the questionnaire as high risk.
"We wanted to identify obstacles such as oxygen that might not have been ordered early enough, or patients not having an adequate discharge destination where they would receive proper care," Gladys Castro, R.N., nurse manager on the med/surgical unit, told Nurse.com.
The committee found patients with chronic diseases including diabetes and heart failure were frequently being readmitted, often for congestive heart failure, according to the article. Nurses analyzed data to identify discharge and admission diagnoses. Case managers and nurses collaborate to identify interventions to reduce readmissions. Med/surgical staff also use the forms to address issues that may arise during hospitalization.
Readmissions have decreased significantly, Castro said, but the article included no specifics. She added that the form "is engaging staff to become agents of change." Based on feedback, the form has been tweaked twice since its introduction.
Other research has shown that positive nurse work environments contribute to lower readmission rates and better outcomes, FierceHealthcare has reported. Better nurse staffing helps, too, but only if other factors contribute to a good work environment. That research followed a 2013 study found that hospitals with higher nurse staffing were 25 percent less likely to be penalized for readmissions than lower-staffed hospitals.