Launched in 2009, the State Action on Avoidable Rehospitalizations initiative, known as STAAR, aims to reduce rates of avoidable rehospitalization in Massachusetts, Michigan, Ohio, and Washington by mobilizing state-level leadership to improve care transitions. With the program two years into its four-year cycle, 148 hospitals are working in partnership with more than 500 cross-continuum team partners. Although there are no publicly available data on whether the project is achieving its primary goal of reducing avoidable rehospitalizations, the effort has so far been successful in aligning numerous complementary initiatives within a state, developing statewide rehospitalization data reports, and mobilizing a sizable number of hospitals to work on reducing rehospitalizations. More than 90 percent of participating hospitals have formed teams to routinely review rehospitalizations with their community-based colleagues.

A short stay unit (SSU) was opened at the Children's Hospital, Boston, with the aim of better fulfilling the needs of pediatric patients with straightforward diagnoses. Using historical and simultaneous comparison groups and controlling for disease severity, the opening of the SSU led to a decrease of between 16.5 and 28.4 percent in the mean length of stay for asthma patients without any increase in the rate of hospital readmission.

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Oncology nurses have a critical role in mitigating the intense vulnerability, loss of control, and fear of the unknown that characterizes the experiences of patients with cancer and their family members. Reliably inquiring about the issues that are at the forefront for patients and their loved ones can encourage a deeper dialogue-where nurses can understand and address the issues that are most important to them. A practical quality improvement approach can help to ensure that processes are in place to assist nurses in devoting time to reliably inquire about "what matters" to each patient at every encounter.