By Courtenay Kohlman, RN, BSN
The importance of strong care transitions is finally receiving the attention it deserves thanks to Medicare's hospital readmissions reduction program. Avoidable readmissions are a serious problem that costs our healthcare system an estimated $17 billion a year in Medicare payments. And with some 20 percent of elderly patients returning to the hospital within 30 days of discharge, the physical, emotional and financial toll on this vulnerable population is high.
Many hospitals choose a top-down approach to reducing readmissions in which administrators assess the situation and prescribe interventions. However, physicians, nurses and other front-line professionals often have a more complete picture of patient needs, communication barriers and other factors that contribute to healthcare fragmentation. For this reason, they are in a unique position to advise — and indeed to lead — the types of process improvements that help to reduce hospital readmissions.
As a practice management consultant with CEP America, I am privileged to work with the ED and hospitalist programs across the country. I have seen hospitals adopt a "bottom-up" approach in which professionals from many disciplines work together to reduce readmissions. So far, the results have been promising across some of our client sites. Here's how one such program approached the problem, and what we've learned so far.