Home From The Editor Tackling readmissions

Tackling readmissions

September 2016

Published in the September 2016 issue of Today’s Hospitalist

HOSPITALISTS FACE a long list of concerns, from patient satisfaction scores to length of stay. But one issue—preventing unnecessary readmissions—consistently tops that growing list.

On our most recent annual career and compensation survey, for example, we asked hospitalists to identify areas their group has targeted for improvement. Readmission rates was no. 1 on the list, with more than half of respondents saying their group is working on that issue.

The interest behind reducing readmissions is no mystery. The Centers for Medicare and Medicaid Services has begun punishing hospitals that have “excessive” rates of 30-day readmissions. In the next fiscal year, those penalties are expected to exceed $525 million.

It turns out, however, that identifying the factors that lead to preventable readmissions is anything but clear-cut. As our cover story explains, researchers studying readmissions are hitting some dead ends.

Take the idea of asking patients about how well-prepared they
 feel for discharge. While that seems like an obvious way to predict which patients are at high readmission risk, researchers didn’t find a consistent correlation between patients’ self-reports and those who bounced back.

Researchers are also developing other tools to identify patients at high risk of readmission. The results are promising, but these tools aren’t quite ready for prime time.

Not all the news about readmissions is discouraging, however. One point that I found interesting, for example, emphasized the role that experience plays in identifying—and preventing—unnecessary readmissions.

Maybe a heart failure patient who bounced back to the hospital could have been referred to a heart failure clinic instead of being readmitted. A junior physician might overlook that option, but not a seasoned physician who’s more familiar with health care resources.

Sounds like a role particularly well-suited for hospitalists.

edoyleEdward Doyle
Editor & Publisher
edoyle@todayshospitalist.com

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