Becker's Hospital Review

32 Executive Briefing: Reducing Hospital Readmissions 3. Educating patients. Involving patients and their families in the care process helps ensure patients have a clear understanding of their condition and treatment plan. This also ensures that patients can follow the post-discharge plan more effectively, says Dr. Gundersen. Once the patient leaves the hospital, the provider has no control over the patient's care. It is therefore essential that patients fully understand the discharge instructions. "When it is not done well, it's the patient who suffers," says Dr. Hildebrand. Patients may take the wrong medication, forget to go for follow-up appointments, experience symptoms they do not understand and then return to the hospital, he says. One strategy hospital providers can use to make sure patients have understood instructions is the "teach-back" method, says Dr. Gundersen, which involves asking patients to repeat the instructions back to providers. 4. Following up post-discharge. According to Dr. Hildebrand, following up with patients after they leave is a proven method of reducing readmissions. know what medication they need to take after discharge and where to get it. "This is often a source of confusion for patients," says Dr. Gundersen. "Errors get made during the medication reconciliation process." According to Dr. Virnich, hospitals also need to communicate the patients' medication requirements to outpatient providers to reduce to the risk of errors. "With CMS penalties on the rise, cutting inappropriate readmission rates needs to be incorporated into every hospital's performance improvement strategy." One way to do this is by implementing a patient callback system, says Daniel Virnich, MD, CMO of TeamHealth Hospital Medicine. Hospitals can follow-up with patients over the phone to see how they are doing, if they are following the discharge instructions and if they have any questions. "If the patient is exhibiting certain symptoms that indicate that they may have to be readmitted, the hospital can intervene and triage the patient to a physician who can help before it gets to a point where the patient may have to be readmitted," says Dr. Virnich. 5. Improving the medication reconciliation process. "The medication reconciliation process is essentially a review of all medications and dosages of medicine that a patient is taking," says Dr. Hildebrand. Hospital clinicians need to make sure patients are taking the necessary medications in the correct dosage while they are in the hospital. They also need to ensure patients With CMS penalties on the rise, cutting inappropriate readmission rates needs to be incorporated into every hospital's performance improvement strategy. Hospitals will have to hardwire the aforementioned steps into their work processes, and physicians and staff must work as a team to be successful in achieving this. "It's first necessary to sell the vision and engage the buy-in of all the key stakeholders," says Dr. Hildebrand. However, with the support of its staff, the willingness of its physicians and the cooperation of the patients, hospitals can reduce readmission rates and thereby prevent reimbursement cuts. n TeamHealth (Knoxville, Tenn.) (NYSE: TMH) is one of the largest providers of outsourced physician staffing solutions for hospitals in the United States. Through its 18 regional locations and multiple service lines, TeamHealth's more than 9,500 affiliated healthcare professionals provide emergency medicine, hospital medicine, anesthesia, urgent care, specialty hospitalist and pediatric staffing and management services to approximately 850 civilian and military hospitals, clinics, and physician groups in 47 states. For more information about TeamHealth, visit www.teamhealth.com.

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