Tackling Hospital Readmission
Hospitals have a problem. Frequently, when a patient is discharged, they are readmitted again within a month. Hospital readmission is a huge drain on resources. In North America hospitals spend billions of dollars a year on patients’ return visits.
For example, one in 20 Canadians who has a heart attack — a common cause of rehospitalisation — is urgently readmitted within a month of being discharged, according to the Canadian Institute for Health Information. An analysis published last year in the New England Journal of Medicine showed the chances of rehospitalisation only increase over time.
Now, obviously, the goal isn’t to prevent individuals from returning to hospital if the need arises. The goal is to provide high-risk patients with the necessary information and tools upon discharge to limit their chances of return.
As times change, hospitals have undergone many transformations to the way care is delivered. From the development of outpatient facilities such as the Jim Pattison Outpatient Care and Surgery Centre here in British Columbia, to the state of the art St. Josef Hospital and Pediatric Clinic in Neunkirchen, Germany, Hospitals are entering an era of change.
So how are hospitals tackling the problem of readmission? The answer is to give patients better follow-up care.
One solution getting growing attention is Project Red — for Re-Engineered Discharge — developed by Boston University. It includes the use of a “virtual discharge advocate” named Louise, who appears as an animated character on an interactive screen rolled up to a patient’s bedside to help in the discharge process.
Facilities in Florida and New Jersey have found another successful tool: nurse intervention and communication. For instance, focusing on nursing education, and have nurses explain discharge plans before patients are discharged.
Medication-related side effects and misunderstandings about what and when to take medicine is a leading cause of readmissions. Nurses, therefore can explain in detail to patients about the medicine they have been prescribed to avoid future complications.
One hospital in Florida devotes a nurse practitioner (NP) to provide transitional care for heart failure patients. The heart failure NP not only provides one-on-one training to the patient in the hospital but also ensures that patients are seen within 7 days of leaving the hospital and receive a follow-up phone call within 48 hours and 10 days of discharge.
For a full overview of hospital readmission challenges and solutions , have a look at this video created by the United States National Health Policy Institute.
Follow-up care is extremely important in reducing readmission rates. All too often, patients are sent out the door without enough information in hand. However, with intervention, an onsite nurse or visiting coach can help cut the rate of readmission’s.