3 Examples of Successful Hospital Readmission Reduction Initiatives

Many hospitals participating in Robert Wood Johnson Foundation's Aligning Forces for Quality initiative have successfully reduced avoidable readmissions, according to an RWJF report.

The report, "How the U.S. Health Care System Can Reduce Avoidable Readmissions," outlines key approaches to reduce readmissions, including working with the healthcare community, identifying and working with at-risk populations, facilitating smoother transitions and collaborating with healthcare providers. The brief also provides examples of successful readmission reduction projects from AF4Q, which includes 120 hospitals led by alliances. Here are three such examples:


1. Redington-Fairview General Hospital (Skowhegan, Maine). The hospital used an assessment called LACE, which gives a risk score based on length of stay, acute admission through the emergency department, comorbidities and ED visits in the last six months. Patients with high risk scores were monitored by care transition nurses and provided more education. In 18 months, the hospital decreased 30-day readmission rates for heart failure patients from 6.9 percent to 0 percent.

2. St. Joseph Health System-Humboldt County (Calif.). The system developed a transition program to ensure patients identified as high risk for readmission receive appropriate follow-up care and support. For example, transition coaches call patients within 24 hours of discharge and make a home visit. The system has reduced its readmission rate by 20 percent since 2009.

3. Central Maine Medical Center (Lewiston, Maine).
The hospital worked with a home care and hospice facility to provide follow-up care for patients. Nurses made home visits to every heart failure patient within a week of discharge. The hospital reduced its 30-day all-cause heart failure readmission rate from 22.8 percent to 17 percent.

More Articles on Hospital Readmissions:

Avoidable Readmissions by Numbers: 8 Statistics
CMS: Hospital Readmissions Down to 17.8%

Study: Medicare, Medicaid Patients More Likely to Have "Bounce-Back" Admissions After ED Discharge

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