Reducing Avoidable Readmissions

07 Aug 2013
A coalition in Minnesota is working to make improvements in readmissions costs and quality of care. The RARE (Reducing Avoidable Readmissions Effectively) Campaign was launched in 2011 by the Institute for Clinical Systems Improvement (ICSI), the Minnesota Hospital Association, and Stratis Health and supported by MN Community Measurement, leader of AF4Q in Minnesota, to address the fragmentation of the health care system that often leads to preventable hospital readmissions. 
Since January 1, 2011, the 83 hospitals participating in the RARE Campaign—representing more than 85 percent of the state's readmissions—have prevented 4,570 avoidable readmissions. This represents a 17 percent reduction in the fourth quarter of 2012 from the 2009 baseline and an estimated reduction of inpatient costs by more than $45 million (based on an estimated $10,500 per admission). RARE has had a large impact because of the large number of participating hospitals. In Minnesota, the ultimate goal is to reduce admissions by 20 percent over 2009 data.
Steve Bergeson, MD, medical director of quality for Allina Health, said the 11 hospitals under Allina Health started working on readmissions because “a readmission wasn’t the care we wanted to give our patients.” One example of a process change Allina Health has put in place for high-risk patients is a transition conference. “A transition conference between the patient, family, the doctor, and nurses helps get the patient the right level of support after the hospital. We’ve found that there’s a 15 percent lower rate of readmission for people who get that conference,” said Bergeson.
RARE’s success also is drawing attention nationally. Four quality improvement organizations across the country (California, Nevada, Arizona, and Florida) have asked and received permission to adopt and adapt the RARE campaign.