Quality collaboratives and campaigns to reduce readmissions: What strategies are hospitals using?

Abstract

Background Reducing hospital readmissions is a national priority, and many hospitals are participating in quality collaboratives or campaigns. Objective To describe and compare the current use of hospital strategies to reduce readmissions in two prominent quality initiatives – STAAR (the State Action on Avoidable Rehospitalization) and H2H (Hospital-to-Home Campaign). Design Cross-sectional. Methods Web-based survey of hospitals that had enrolled in H2H or STAAR from May 2009 through June 2010, conducted from November 1, 2010 through June 30, 2011 and (n= 599, response rate of 91%). We used standard frequency analysis and multivariable logistic regression to describe differences between STAAR and H2H hospitals. Results Many hospitals were not implementing several of the recommended strategies. Although STAAR hospitals tended to be more likely to implement several strategies, differences were attenuated when we adjusted for region and ownership type. In multivariable models, STAAR hospitals compared with H2H hospitals were more likely to ensure outpatient physicians were alerted within 48 hours of patient discharge (63% versus 38%, P-value < 0.001), and more likely to provide skilled nursing facilities the direct contact number of the inpatient treating physician for patients transferred (53% versus 34%, P-value = 0.001). H2H hospitals were more likely to assign responsibility for medication reconciliation to nurses usually or always (80% versus 54%, P-value = 0.001) and more likely to give most or all discharged patients referrals to cardiac rehabilitation services (59% versus 41%, P-value = 0.001). Conclusions Substantial opportunity for improvement exists for hospitals engaged in STAAR or H2H quality initiatives.

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations

“…Hospitals frequently fail to implement strategies commonly recommended to reduce rehospitalisation [25]. Heart failure admission rates were demonstrated to vary considerably between institutions [26].…”

Interprofessional Communication Patterns During Patient Discharges: A Social Network Analysis

“…1,[6][7][8] Transitions of care initiatives, such as the Better Outcomes for Older Adults through Safe Transitions, and quality collaboratives, such as the State Action on Avoidable Rehospitalization initiative, provide approaches and strategies at the unit level to improve this process. [9][10][11] A prerequisite for these initiatives, however, is high-quality communication and collaboration between the myriad of providers and patient involved in the discharge process.…”

Hospital Readmission and Social Risk Factors Identified from Physician Notes

“…Consequently, many health systems have launched care management and discharge transitions programs to assist vulnerable patients in navigating the complexities of transitions in care, including programs that create partnerships with community physicians, promote sharing of medical records, and assign accountability for longitudinal management to specific clinical staff (Bradley et al. , , ).…”