Issue link: https://beckershealthcare.uberflip.com/i/626854
22 REDUCING READMISSIONS R educing readmissions is an ongoing battle for hos- pitals, exacerbated by the threatening brunt of fi- nancial penalties. Although readmissions may be considered a system problem — a number on a spread- sheet for executives to worry about — hospitalists and primary care physicians are among those who can being making a dent in readmission rates by improving the dis- charge process. e major force behind this change is the Affordable Care Act, according to Ann Whitehead, the vice president of risk management and patient safety of the Cooperative of American Physicians' CAPAssurance program. "Healthcare reform is not just about reducing costs, it's about closing gaps in communication among healthcare providers leading to improved quality, safe discharges and decreased readmissions," says Ms. Whitehead. "Hospitals are faced with the challenge of getting active participation from physicians and staff in identifying the specific prob- lems associated with an inadequate discharge process." A major factor that contributes to readmissions is physician communication. Good communication among and between hospitalists, primary care physicians and patients during the discharge period is pivotal to boost- ing patient safety and reducing the likelihood of an un- planned trip back to the hospital. Unfortunately, this communication happens less than it should. One study published in the Journal of Hospital Medi- cine revealed direct communication from hospitalists to primary care physicians occurred only 3 to 20 percent of the time at discharge. Although direct communication via face-to-face inter- action or phone call is ideal, it is not always possible con- sidering how full most physicians' schedules are. at's where discharge summaries come in. Discharge summaries provide a means for hospitalists to communicate with both patients and primary care phy- sicians. e problem is, discharge summaries are really only conducive to moving information and responsibility in one direction — from the hospitalist to the patients and primary care physicians. Also, discharge summaries are only helpful when they are filled out in their entirety and in a timely fashion, which is not always the case. Research published in the Annals of Internal Medi- cine found less than one third (12 to 33 percent) of pri- mary care physicians involved in the study were able to access their patient's discharge summaries at the time of the patient's first post-discharge visit. is failure in com- munication could mean leaving primary care physicians unaware of a patient's diagnosis, potentially actionable test results, reconciled discharge medications, required follow-up care and confirmed or pending test or proce- dure results. at said, breaking down the communication silos between hospitalists and primary care physicians and improving how they use discharge summaries is a must, according to Ms. Whitehead. "Risk management and patient safety providers are in a unique position to influence, change and reduce adverse events, readmissions and potential liability by providing education and support for discharge plan development. is starts with fostering a culture of teamwork and a mindset of 'teamwork and cooperation,'" says Ms. White- head. "is will result in a more comprehensive discharge process and transition of care." In addition to enhancing communication among phy- sicians, improving communication between physicians and patients is also important. ere are new mobile ap- plications and technological tools that have been creat- ed to this end, but Ms. Whitehead suggests some of the smallest changes are the ones that can have the greatest impact on patients. Many adults in the U.S. read below a 5th grade level, so if a physician tells patients to cut "salt" from their diet in- stead of "sodium," it can make a big difference in patients' Discharge Summaries: The Key to Improving Physician Communication, Reducing Readmissions By Shannon Barnet