Allegheny Health Network achieved this through the implementation of a home visit program. After discovering the high readmission rate in March 2012 was at 19.2 percent, Allegheny officials formed the high-risk care team — nurses, social workers and paramedics — to meet daily and review details of recently discharged patients they suspected might return. Certain patients are then visited at home by a healthcare professional to ensure that they are following discharge instructions properly.
“We go outside the walls of the hospital for early recognition of symptoms going bad,” said Lori Shotts, a registered nurse at Allegheny Valley Hospital, told TribLive. “We want to keep the patient at home where they want to be.”
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