By Stephen S. Mills
As you may have heard in the news, recently-enacted health care reform legislation will assess penalties starting in 2013 against hospitals with higher than average readmission rates for certain conditions, such as heart failure, heart attack and pneumonia. Reducing hospital readmission rates has emerged as a core strategy at both state and federal levels to reduce health care costs.
All hospitals need to work on reducing readmissions, because it is the right thing to do for patients. Most patients look forward to going home and staying there to recuperate. A readmission can have a negative impact on a patient’s health outcome, which affects the overall hospital experience.
New York Hospital Queens has been actively working to reduce preventable readmissions for several years. Over the past year, New York Hospital Queens has reduced readmissions below the New York State average of 20.9 percent.
Hospital Plan of Curbing Readmissions
To curb readmissions, New York Hospital Queens has a five-point plan developed by our medical team of nurses, doctors, case managers and community partners (such as the Visiting Nurse Service and local nursing homes).
• The medical team coordinates and prepares a patient’s discharge plan early during the patient’s stay and makes arrangements for after-hospital care.
• The medical team educates the patient and family by explaining medication information, such as which medications the patient will need, and the time to take the medication and the appropriate dosage.
• The hospital’s palliative care team counsels a patient and empowers them to communicate how they would like to handle future health care plans.
• New York Hospital Queens has a discharge phone call program that helps identify patients at risk for readmission. On those follow-up phone calls, nurses ask about patient symptoms. Nurses can identify patients who may think their symptoms are “abnormal” but in actuality, those symptoms can be expected, and vice versa.
• The hospital also identifies help the patient may need after discharge. Options may include going to a skilled nursing facility after discharge, getting in-home “visiting nurse” assistance, or, now, a new option, the “Transitional Care Unit” at New York Hospital Queens. The soon-to-open unit was developed for patients needing up to 20 days of post-acute care, which is run by a skilled nursing team from the Silvercrest Center for Nursing and Rehabilitation.
As illustrated, there are many ways for a hospital and a patient’s medical care team to reduce readmissions. However, this responsibility does not lie with the hospital and medical care team alone.
The patient, with the help of family, will need to closely heed discharge instructions, manage medicines correctly, abide by follow-up doctor visits and communicate concerns immediately back to the primary physician or hospital. Check if instructions given are complete and repeat-back those instructions to the hospital caregiver. Finally, ask, “Do I have this right?” and make sure the patient and family members know the danger signs to look for, so as to avoid an overreaction or underreaction.
New York Hospital Queens is strongly committed to providing our patients top quality outcomes and improving the patient and family experience—right here in Queens. By incorporating the hospital’s responsibilities along with patient/family responsibility in the after-hospital care of the patient, we hope to reduce the risk of readmission even further and make the patient’s health care experience more satisfying, with even better outcomes.
Stephen S. Mills is President &Chief Executive Officer of New York Hospital Queens