To prevent patient readmissions, stop playing 'whack-a-mole'

What's the key to managing readmission risks? Not playing whack-a-mole by quickly combatting problems as they arise, according to Ray Hess (pictured), vice president of information management at West Chester, Pa.-based Chester County Hospital.

Hess, speaking Wednesday at the Healthcare Business Intelligence Forum in Washington, D.C., discussed his hospital's strategy for preventing readmissions, based on guidelines from the Boston University Medical Center-based Project RED (re-engineered discharge).

Data governance, while it can be a "snoozer," Hess joked, is hugely important, as is the ability to define readmissions. Payers, he continued, have different definitions of readmissions; every report must clearly define what type of consistent data it's showing.

What's more, Hess said, when it comes to approaching reducing readmissions, it is important to not take an approach like the characters on Crime Scene Investigation; for example, picking up the pieces after damage is already done, finding out who the bad guys are, solving the case and waiting for the next crime to occur.

"Hospitals, instead, should take a much more preventative approach," Hess said.

While implementation of this new organization-wide mentality hasn't been easy at Chester, and is very much still a work-in-progress, Hess told FierceHealthIT that it all starts with changing processes and a "flashpoint" mentality--clear and decisive action in real time. Hospitals, he said, must work to understand the factors effecting readmissions, create a system to react in real-time to prevent readmission, focus on adherence to the identified strategy and evaluate effectiveness of their approach.

"We researched factors associated with readmissions and created automated processes to identify patients who are at risk for readmission," Hess said.

He added that hospital staff must learn to catch readmissions before they happen and be ready to counter with a strategic response, gaining information immediately from failures.

"We don't wring our hands--get the information from the patient while they're at the hospital," Hess said. "They'e your best source of figuring out what is and isn't working."

Finally, Hess said, it's important to create trends reports once all of those new workflows are in place. That way, if readmission rates aren't improving, it will be easier to ensure that processes are being followed.

"Preventing readmissions ... is very much a culture shift and a lifestyle change in how you run your institution," Hess said.

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