Reducing Readmissions
 
At least 7.5 million people have signed up for health coverage through the Affordable Care Act exchanges, and the number is still rising. The question now is where exactly do these patients go to find their affordable care?
 
The Aligning Forces for Quality (AF4Q) program in Detroit, led by the Greater Detroit Area Health Council (GDAHC), is helping its residents easily locate the care they need with its Find MI Care initiative. Patients in Michigan looking for a doctor or other health care services can use the Find MI Care website (...

When MN Community Measurement, leader of AF4Q in Minnesota, first started publicly reporting data, the belief was that patients would use the data to make choices about what doctor to see. This, in turn, would drive improvement. What has been surprising, according to Jim Chase, president of MN Community Measurement, is the amount of attention providers have given the public reports and the comparisons they make to their peers’ performance. “We’ve been using it in a variety of ways: to improve our services, to improve our clinical workflows, to implement tools so we could...

Quality Field Notes features key lessons learned by regional alliances of clinicians, patients, and payers in Aligning Forces for Quality communities as they work to transform local health care and provide models for national reform. The first topic in this series focuses on reducing inappropriate emergency department use. Seventy percent of visits to emergency department (ED) are not true emergencies or could be prevented with...

AF4Q in South Central Pennsylvania is empowering hospital staffs in order to avoid hospital readmissions. York & Gettyburg Hospital have implemented a program “Purposeful Pause” using LEAN thinking stolen from the automobile industry. All staff have the ability to “stop the line” in relation to patient discharge if they anticipate problems.  If anyone involved in the patient’s care feels that anything is getting in the way of the patient transition to their next care phase or puts them in danger of a readmission, a Purposeful Pause allows the staff...

Aligning Forces for Quality of South Central Pennsylvania, in partnership with the York County Area Agency on Aging, the Adams County Office for Aging, and other regional organizations, is leading targeted efforts to provide care transitions services to Medicare beneficiaries discharged from York, Hanover, and Gettysburg Acute Care Hospitals. Together, AF4Q and the York-Adams Care Transitions Coalition have formed a strong collaborative body and are creating a community-wide infrastructure for effective care transitions for seniors.

In March 2013, the Centers for Medicare and...

What is the value of a good night’s sleep in your own bed? Hospital readmissions are costly for the health care system and stressful for patients and their families. Currently, nearly one in five Medicare patients discharged from hospitals in Minnesota wind up being readmitted within 30 days. The worst part? Many readmissions are avoidable. A coalition in Minnesota is aiming to help patients spend more nights out of the hospital and avoid potentially preventable readmissions.

The RARE (Reducing Avoidable Readmissions Effectively) Campaign was launched in 2011 to address the...

As part of AF4Q, hospitals, ambulatory care providers, community health centers and other state and local agencies are working together to improve quality and reduce costly hospital readmissions. Most of the AF4Q’s 16 Alliances indicated efforts to report readmission rates as one of their key strategies for addressing cost and efficiency. Rates of hospital readmission are important outcome measures for assessing the performance of the health care system. While some hospital readmissions may be necessary and appropriate, many are considered unnecessary or avoidable, and serve as...

As part of the Robert Wood Johnson Foundation’s signature effort to improve the quality of health care 150 hospital teams participated in prestigious national program over the last 18 months.

Ninety percent of the hospital teams participating in this AF4Q hospital quality improvement collaborative improved the quality of care for their patients in measurable ways, resulting in hundreds of avoided readmissions; improved patient safety; standardized data collection on patients’ race, ethnicity and language preference (R/E/L), a critical part of tracking and meeting...

To decrease its 30-day readmission rates, Samaritan Albany General Hospital created a comprehensive patient education and post-hospital follow-up system for its heart failure patients. This multi-disciplinary approach to heart failure care and follow-up consisted of several strategies, including working toward standardizing congestive heart failure education materials within the entire health system, implementing the teach-back method, distributing “Heart Failure Care Kits” upon admission, and conducting follow-up phone calls after discharge. As a result, Samaritan Albany...

Margie Namie, RN, MPH, CPHQ, divisional vice president of quality at Mercy Health in southwest Ohio, was honored to be named one of 73 Innovation Advisors (IAs) in the first cohort of the Centers for Medicare & Medicaid Services Innovation Center (CCMI). Her participation in the program brought an added bonus: reductions in readmissions and costs.

Read the rest of this AF4Q Bright Spot here.

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