Initiatives to Prevent Readmissions: Still a Challenge

Grace C. Huang, MD

Hospitals enrolled in programs to prevent rehospitalizations still have gaps in complying with best practices.

To characterize hospitals' efforts to lower readmission rates, investigators surveyed 599 hospitals enrolled in either of two quality initiative campaigns: STAAR (STate Action on Avoidable Rehospitalization), a state-based collaborative available to communities in Massachusetts, Michigan, Washington, and Ohio, and H2H (Hospital-to-Home), a national campaign focused on the care of myocardial infarction (MI) and heart failure patients. The survey response rate in 2010–2011 was 91% and included 55 STAAR and 532 H2H hospitals.

Adherence to recommended strategies was low in several notable areas. Overall, 50% of hospitals had dedicated quality-improvement teams to prevent readmissions in MI patients. Only one third of hospitals monitored the number of patients with follow-up appointments within 7 days, and 12% tracked readmissions to outside hospitals. Pharmacists rarely were involved in medication reconciliation. Differences between the two types of hospital programs were not significant in adjusted analysis.

Citation(s):

Bradley EH et al. Quality collaboratives and campaigns to reduce readmissions: What strategies are hospitals using? J Hosp Med 2013 Sep 6; [e-pub ahead of print].