Reduction of Hospital Readmission Rates
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Significance of the topic and its implications for nursing practice.
A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.
Reduction of Hospital Readmission Rates
Readmission of patients within 30 to 180 days of discharge is one of the hindrances to the provision of quality healthcare. Research has shown that approximately 20% of Medicare patients in the US are admitted back to hospitals 30 days after being discharged (Brunner-La Rocca et al., 2020). Notably, underlying complicated multimorbid conditions, as well as functional and cognitive impairments are some of the main causes that increase a patient’s possibility of being readmitted after being discharged from the hospital (Page, 2018). Further, Brunner-La Rocca et al. (2020) point out that patients are more likely to suffer from infectious diseases, such as hospital-acquired pneumonia and urinary tract infections, during hospitalization, which necessitates readmission after being discharged. Poor work environments, limited nurse staffing, and inadequate nurse education are also critical factors that increase preventable hospital readmissions (Page, 2018). Moreover, Page (2018) indicates that the risk of hospital readmission among patients increases if the healthcare transition from the hospital to their homes is poor. This includes ineffective communication between the caregivers and the patients as the latter recuperate at home.
Unplanned hospital readmission has negative financial implications on the patients, hospitals, and even the state and federal governments. Considering that patients are at a higher risk of complications and tend to stay longer in hospitals during readmission compared to the first admission, this requires hospitals to use more resources and funds (Hughes & Witham, 2018). According to Page (2018), the hospital costs due to readmission of roughly 3.3 million US adults in 2015 were estimated at $41.3 billion. Further, Upadhyay et al. (2019) indicate that in the long-term, readmission of patients suffering from diseases, such as heart failure and pneumonia minimizes a hospital’s profitability due to increased use of resources, including the need for more caregivers. Another negative impact of hospital readmission is that it increases the risks of patients with chronic diseases suffering from undesirable health outcomes (Page, 2018). According to Brunner-La Rocca et al. (2020), hospital readmission increases the workload on nurses and other caregivers, which may result to work burnout and high employee turnover.
Addressing the issue of hospital readmission is critical as it will help to enhance healthcare quality in hospitals; thus, improving the well-being of Americans. Minimizing hospital readmission will have a positive effect on nursing practice as it will necessitate an increase of nurses, leading to more direct patient care. Furthermore, reducing preventable hospital readmission is vital as it will improve the healthcare transition after patients are discharged. This means that healthcare providers will perform more follow-up interventions with their patients; hence, improving healthcare provision. Handling this issue will also enhance the financial performance of hospitals both in the short- and long term, resulting in the acquisition of better medical equipment and improvement of the work environment. As a result, this will enable caregivers to gain the necessary training needed to improve healthcare transition.
In order to reduce readmissions, it is proposed that hospitals should adopt the Coordinated-Transitional Care (C-TraC) program. According to Page (2018, p. 10), the C-TraC program is a “telephonic, nurse- and protocol-driven program designed to reduce 30-day all-cause hospital readmissions.” This program requires caregivers to make follow-up telephone calls to their patients during the transition period between the hospital and their homes, as well as after they are discharged (Page, 2018). Also, the C-TraC program requires nurses to provide education to patients before discharge. Hence, as caregivers become more involved in caring for patients, it minimizes the likelihood of readmissions.
Brunner-La Rocca, H., Peden, C. J., Soong, J., Holman, P. A., Bogdanovskaya, M., & Barclay, L. (2020). Reasons for readmission after hospital discharge in patients with chronic diseases—Information from an international dataset. PLOS ONE, 15(6). https://doi.org/10.1371/journal.pone.0233457
Hughes, L. D., & Witham, M. D. (2018). Causes and correlates of 30 day and 180-day readmission following discharge from a medicine for the elderly rehabilitation unit. BMC Geriatrics, 18(1). https://doi.org/10.1186/s12877-018-0883-3
Page, T. (2018). Implementing the Coordinated-Transitional Care Program to Reduce All Cause Readmissions. Doctor of Nursing Practice Capstone Projects. 32. https://encompass.eku.edu/dnpcapstones/32
Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission rates and their impact on hospital financial performance: A study of Washington hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56, 004695801986038. https://doi.org/10.1177/0046958019860386