JDH, a 229-bed hospital under Farmington-based University of Connecticut Health Center, established the Heart Quality Team in 2009 to improve the hospital-to-home transition and reduce 30-day all-cause readmissions among heart failure patients. The HQT and quality improvement effort included several components:
• Daily identification of heart failure patients and email notification of key staff members and physicians
• Patient education by floor nurses
• Evaluation and supplemental education by nurse practitioners
• Patient meetings with staff from nutrition, pharmacy and social work
• Prior to discharge, scheduling of a seven-day follow-up appointment
• Follow-up phone calls 48 to 72 hours post-discharge
• Team of community service providers to care for patients post-discharge
Chart reviewers estimated between 20 and 30 percent of readmissions were preventable in 2008, prior to the intervention. The readmission rate decreased from 83 percent in 2008 to 61 percent in 2011, a 28 percent reduction.
Before the QI program, most preventable readmissions were deemed preventable due to lack of close follow up after discharge. After the QI program, the percentage of preventable readmissions decreased and the causes of readmission were more diverse.
More Articles on Hospital Readmissions:
Recording Discharge Instructions Cuts Readmissions 15% in 6 Months
Do Complaints About the Readmission Measure Ignore Hospitals’ Progress?
Study: Early Physician Follow-Up Lowers Readmission Risk
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