Outcomes Measurement and Data Management Project: Hospital Readmissions
Charmein Garner and Celeste Thomas
Loyola University New Orleans
Outcomes Management Project
Defined Issue or Problem of Interest
The selected problem of interest is hospital readmissions after being discharged from hospitals/medical facilities. Several patients enter the hospital and soon after discharge are catapulted back into the seemingly revolving doors of the hospital. Readmission rates affect all areas of healthcare. Center for Medicare and Medicaid (CMS) has targeted readmissions as a guideline of poor quality of care. Engaging patients during their inpatient admission as they transition to ...view middle of the document...
Overview of Research on Management of Selected Issue
A review of current research on management of hospital readmissions among the elderly, particularly with those who have a diagnosis of congestive heart failure reveals that decreasing hospitalizations in the elderly has become a priority for national health plans and hospitals (Legrain et al. 2011). A reduction in readmissions can be attained through the implementation of inpatient pre discharge, outpatient post discharge and intermittent admissions involving the following modifiable risk factors:
drug-related problems (DRPs) (iatrogenic illness, adherence problems, and under treatment), underdiagnosed and undertreated depression, and protein-energy malnutrition. Systemic problems such as lack of patient education and insufficient coordination between health professionals, especially during care setting transitions, also contribute to readmissions (Legrain et al. 2011, p. 2018).
One solution to the predicament of recurrent admissions of the elderly is the utilization of disease-management programs which focus on case management of either one or all of the patient’s disease processes. The programs include coordination between health professionals focusing on case management and patient education (education regarding disease processes, medication, diet, etc.). It also suggests multiple, holistic, and comprehensive discharge planning interventions to take place while the elderly patient is still hospitalized. The discharge planning includes three to six month follow ups from the inpatient facility (Legrain et al. 2011, p. 2018).
Care which takes place pre, during, and post hospitalization directly impacts patient outcomes. “Chronic medical illness requires close outpatient management, and early outpatient follow up after hospitalization, as well as disease management and patient education, this can reduce readmissions among both white and minority populations” (Joynt, Orav, & Jha, 2011).
According to Joynt, Orav, & Jha (2011), elderly black patients have higher 30 day readmission rates than white patients’ diagnoses with CHF, pneumonia, and AMI. There is a 13% higher chance of readmission of black patients than white patients. Patients discharged from minority-serving hospitals have a There is a 23% higher chance of readmission for patients discharged from predominately minority serving facilities versus that of non-minorities.
A Clearly Defined Target Population of Interest
The population we have chosen to evaluate for this topic is the elderly, those who are age sixty-five and older. The elderly population has been selected because they are the fastest growing population. By 2030, adults 65 and older will double to approximately 71 million, impacting the nation’s health care system. Eighty percent of the growing elderly population has at least one chronic condition, and fifty percent have at least two chronic conditions. According to Nolan (2009), the elderly...