Despite the increasing speed of new technologies implementation, such as electronic health records, may hospitals face the issue of readmissions and must elaborate on the process of patient transition from one care setting to another manually. Financial fines and other difficulties brought by readmissions urge medical professionals to integrate efficient processes and procedures to move patients fast and safely between settings. This paper will present a memo that describes the improvement of provider communication policy and ways to resolve readmissions.
Readmission rates within 30-days in U.S. hospitals from 2015 to 2017 account for 15.3%, according to statistics (Elflein, 2019). It is also reported that the cost of readmission for different target groups can be substantial; for instance, the average cost of readmission for a patient aged 65 or older was $13,800 (United Health Foundation, n.d.). The Centers for Medicare and Medicaid Services (CMS, 2014) indicates that the “transition of care” from one care unit to another brings breakdowns in processes and negatively influences patients due to miscommunication between providers.
Researchers indicate that hospitals’ significant issue in reducing readmission is provider communication and the inconsistent flow of information exchange between care providers and institutions (Mansukhani et al., 2015). Communication issues include access to medication, admission to the new setting, health information exchange, care plans, and other interaction points. To address these issues, the latest procedures and policies should be implemented to resolve communication problems and reduce readmissions.
A policy that is suggested to integrate to help hospitals manage their operations efficiently is based on the Institute for Healthcare Improvement recommendations. The SMART Discharge Protocol can be implemented to enhance communication and manage relationships between various settings efficiently (“SMART Discharge Protocol,” n.d.). Signs, Medications, Appointments, Results, and Talk with me variables should be included in databases that can be easily transferred via EHR and online systems (“SMART Discharge Protocol,” n.d.).
First, to implement a new policy properly, a team of clinical and managerial leaders and other stakeholders should be established and prepare a report on the readmissions situation to inform them. Second, the analysts should create a hospital gap analysis suggested by the U.S. Agency for Healthcare Research and Quality (2016) to identify best practices to tackle communication challenges between the care provider and the institution. Third, the readmission action plan can be developed using a worksheet presented by the Agency for Healthcare Research and Quality to implement the SMART Discharge Protocol.
The SMART Discharge Protocol is proved to bring valuable results when it comes to the reduction of readmission levels (McLaughlin et al., 2019). To substantially influence readmission rates, the hospital management team should integrate the protocol’s variables in the instructions and rules for medical employees and introduce new procedures on working with patients to improve provider communication and avoid the increase of readmissions level. The new policy and practice should include standard key performance metrics (readmissions rate and financial expenditures) for all team members to ensure that employees will be compliant and track medication reconciliation at three stages: on admission, transition, and discharge.
To conclude, one can state that accurate medication reconciliation and the transition is essential for hospitals when it comes to readmission rates and patient-central healthcare. Readmissions can influence patient results and expenditures that hospitals must bear due to financial penalties established. Therefore, it is crucial to utilize evidence-based policy to facilitate patients’ transition between settings and apply appropriate methods and technologies, such as home visits, EHR, and post-discharge telephone calls.
References
Agency for Healthcare Research and Quality. (2016). Designing and delivering whole-person transitional care: The hospital guide to reducing Medicaid readmissions. Web.
Centers for Medicare and Medicaid Services. (2014). The transition of care summary. Web.
Elflein, J. (2019). 30-day hospital readmission rates in the U.S. by selected disease. Statista.
Mansukhani, R. P., Bridgeman, M. B., Candelario, D., & Eckert, L. J. (2015). Exploring transitional care: evidence-based strategies for improving provider communication and reducing readmissions. P&T: A peer-reviewed journal for formulary management, 40(10), 690–694. Web.
McLaughlin, K., Olsan, T., Hettler, D., & Davey, A. (2019). Utilizing the SMART Discharge protocol to promote surgical oncology patients’ readiness for discharge: A nurse-led initiative. ONS Congress. Web.
SMART Discharge Protocol. (n.d.). Institute for healthcare improvement. Web.
United Health Foundation. (n.d.). Hospital readmissions – ages 65-74. Web.