Reducing Hospital Readmissions--Lessons from Top-Performing Hospitals
Significant variability in 30-day readmission rates across U.S. hospitals suggests that some are more successful than others at providing safe, high-quality inpatient care and promoting smooth transitions to follow-up care. This report offers a synthesis of findings from four case studies of hospitals with exceptionally low readmission rates—McKay-Dee Hospital in Ogden, Utah; Memorial Hermann Memorial City Medical Center in Houston, Texas; Mercy Medical Center in Cedar Rapids, Iowa; and St. John’s Regional Health Center in Springfield, Missouri. Hospitals’ environments contribute to their capacity to reduce readmissions. The four hospitals studied are influenced by the policy environment, their local health care markets, their membership in integrated systems that offer a continuum of care, and the priorities set by their leaders.
Performance Improvement Strategies
- Invest in quality first: care for patients correctly and readmission rates fall, performance on quality measures improves, and savings are realized as byproducts.
- Use health information technology (e.g., electronic health records, patient registries, and risk stratification software) to improve quality and integrate care across settings.
- Begin care management and discharge planning early, target high-risk patients, and ensure frequent communication across the care team.
- Educate patients and their families in managing conditions. Teach at a level appropriate to patients and ensure they understand and can teach back key instructions.
- Maintain a “lifeline” with high-risk patients after discharge through telephone calls, telemonitoring, or other practices.
- Align hospitals’ efforts with those of community providers to provide a continuum of care. While this may be best achieved in integrated systems, such cooperation can be facilitated through collaborative relationships among hospital and community providers.
