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Reducing patient readmissions

Patient readmission carries a heavy penalty to hospitals. Just last year the Centers for Medicare & Medicaid Services fined a record number of hospitals, with a higher fine average than ever before. Hospitals are under a lot of pressure to reduce the number of patients who are readmitted to the hospital with already-treated issues.

A number of initiatives have cropped up across hospitals aiming to reduce readmission through post-discharge care, follow-up appointments, and medical adherence plans for patients. However, hospitals must not only address what happens after a patient leaves the hospital, they must also be prepared to change how the patient is cared for the first time around.

According to FierceHealthcare Eugene Litvak, Ph.D., president and CEO of the Institute for Healthcare Optimization in Newton, Massachusetts, suggests that initial patient flow is to blame for patient readmission numbers. Hospitals are staffed according to the average number of beds occupied. This number changes throughout the day, with some hours bringing fewer patients, and other hours bringing many more patients than expected. At peak hours hospital staff become overburdened, leading to a lower quality of care and increased chances of patient readmission.

Staffing to the peak is not conducive to hospital operations and is therefore not a viable solution to the problem. Litvak instead suggests that hospitals should work to avoid premature discharges, and should reconsider nurse-to​-patient staffing ratios. Premature discharges, even when the patient seems in good health, and their bed is needed by a patient in more dire condition, result in a high level of readmission due to a lack of supervision. To offset this issue a larger number of nurses should be hired who are able to handle critical care of patients, and who are able to recognize when a patient is in need of extra supervision. The addition of these nurses then reduces the number of readmissions, while also providing patients with better care.

Patient Approved can help doctors judge the reasons for patient readmission through patient feedback. This information can then help hospitals establish a plan of action to reduce readmissions.