A hospital readmission is a situation or occurrence when a patient who had been discharged from a hospital is admitted again within a specified time interval. Readmission rates have increasingly been used as an outcome measure in health services research and as a quality benchmark for health systems.

 

In the United States hospitalizations account for nearly one-third of the total $2 trillion spent on healthcare. In the majority of cases, hospitalization is necessary and appropriate. However, a substantial fraction of all hospitalizations are patients returning to the hospital soon after their previous stay. These rehospitalizations are costly, potentially harmful, and often avoidable. This is why organizations and scholars always work on finding the best ways of Reducing Readmissions in Healthcare.

 

Evidence suggests that the rate of avoidable rehospitalization can be reduced by improving core discharge planning and transition processes out of the hospital; improving transitions and care coordination at the interfaces between care settings; and enhancing coaching, education, and support for patient self-management.

 

There are various ways of reducing readmissions in healthcare some of the major ways are:

  • Increasing Patient Engagement
  • Putting Nurses back in the classroom
  • Reducing Blood Transfusions
  • Preventing Surgical site infections

 

All these are effective ways and in this article, I’m going to discuss in detail how hospitals can prevent surgical site infections.

Preventing surgical site infections




This is a smart approach, as a 2015 study published in the Journal of the American Medical Association found that surgical site infections are the most common reason for unplanned readmissions. A good example of this is the case of New England Baptist Hospital.


New England Baptist started with the hospital's wound care committee, which includes eight nurses who were certified in wound care as well as one surgeon. The team researched the best dressing supplies and studied how often wound dressings were being changed and by whom.The team discovered a great deal of variability in how patients' wounds were being dressed, related to the use of proper hand hygiene, the appropriate use of tape, and the different providers who were actually dressing patients' wounds. The team found that dressings were being changed by a physician assistant or a nurse, which meant that many people were picking up a dressing and looking at a wound, which increased the chances of variability.


The hospital's current protocol then involved dressings that were only changed once before the patient was discharged, and some weren't changed at all. If the dressing is changed, it must be changed by a nurse who follows the appropriate protocols. Patients can then remove the dressing at the appropriate time once they get home.

As a result, fewer staff members are touching patients' wounds and wounds had less exposure to the environment, which meant fewer infections. The wound care team also educated the entire clinical team about wound care protocols twice a year to increase awareness.

While the statistical prediction of infection (SPI) for knee surgeries at the hospital,
per the Massachusetts calendar year 2013 Healthcare-Associated Infections Data Reports the latest statistics available in the hospital's 2014 quality report is 13.9,
the actual rate of infections is 5 infections; the SPI rate for hip surgeries is 12.2,
but the actual rate at the hospital is 7 infections.

Only .8% of New England Baptist Hospital's hip, knee, and spine surgeries result in unplanned 30-day readmissions per 1,000 patients, reports the hospital; all-cause 30-day readmissions are 1.2% per 1,000 patients, according to its 2014 quality report. The hospital is actively working to meet its aspirational goal of zero readmissions for its patients, according to its quality report.

Reducing readmissions contributes significantly to lowering the overall costs of healthcare in U.S. hospitals, but tracking the metrics and reporting the results can be onerous. The process is greatly facilitated by analytics applications supported by an enterprise data warehouse to guide improvement projects. These are the keys to developing best practices that will ultimately help hospitals reduce readmissions, and avoid the penalties that result from noncompliance.