A retrospective review of 30-day patient readmissions in a small community hospital to determine appropriate interventions for improving readmission rates

Abstract

Nationally, healthcare is in a state of substantial reformation. Quality and cost effectiveness of care provided, as well as evaluation of patient outcomes have become high priorities for healthcare organizations. Presently, national healthcare initiatives have a strong emphasis on improving quality of patient care through reduction in patient readmissions. Not only are hospital readmissions negatively impacting the quality of life for the patients being readmitted, but they are also costly to healthcare organizations and the federal government. This project is an effort to align practices at Bozeman Deaconess Health Services (BDHS), a small community hospital, to meet the current and upcoming federal regulations created through the Patient Protection and Affordable Care Act (PPACA), which aims to improve patient quality of care through reduced readmissions (Stone & Hoffman, 2010). This legislation mandates decreased reimbursement for services if a facility has high 30-day patient readmissions related to the three core measures of Congestive Heart Failure (CHF), Acute Myocardial Infarction and Pneumonia (PNM). A thorough assessment of the patient population at BDHS took place in the form of a retrospective review of patient readmission data from January 2009 through December 2010. Literature suggests common contributors to patient readmissions are poor communication, patients not following their care instructions, inadequate follow-up care and the location to which patients are discharged (Stone & Hoffman, 2010). Assessing the retrospective patient readmission population data for any trends and patterns, will better allow for appropriate intervention selection based on current available evidence for standards of care that reduce readmission rates. This project proposes policy and care process recommendations to incorporate the standard of care into nursing practice at BDHS in an effort to comply with federal regulations, decrease risk for financial penalties and most importantly to improve the quality of patient life by reducing 30-day readmission rates.