Nursing: Hospital Readmission

Analyzing the number of people that experience unplanned readmissions to a hospital is one of the methodologies that help determine the quality of hospital care. A perfect example of unplanned readmission is like a patient is take back again to the hospital for a surgical wound infection that occurred after prior surgery in the hospital. However, impromptu hospital readmissions are not always connected with the previous visit; some are not preventable. Insurance companies and other payers view readmissions as wasteful spending. Reducing readmission rates is vital and will go a long way in ensuring VCRH is successful. It is ethically dilemmatic to reduce the number of patients readmitted without making patients feel they are denied medical care. Primarily, readmissions have been associated with the quality of care provided to patients at various stages of the clinical pathway. The measure of readmission rates is imperfect and has some substantial limitations (Friebel, 2018). And because of this, some reasons for readmission cannot be controlled by a hospital, and they do not reflect a patient’s preference.

Before going much further into resolving any menace, it is always essential to understand its root cause. The same applies in the case of reducing rates of readmissions. This is a sensitive approach as it will involve invading the personal medical histories of most of the patients. It would, therefore, be ethical to first ask for permission and let the patients be aware of it. There are also other reasons, such as food insecurity, poor housing, among other social determinants of health, that might compel a patient to seek medical care again after discharge. Therefore, hospitals can implement a protocol for screening social determinants of health to pinpoint a more likely readmitted patient before discharge. To keep such people away from the hospital after being discharged, they can be connected to community-based supports before the initial hospitalization.

Due to the costliness of readmissions, policymakers in the U.S have also been working on reducing its rate. There is a law that imposes a penalty on hospitals more than the anticipated 30-day readmission rates. Presumably, this penalty is intended to stimulate hospitals to invest in finding and implementing resolutions to over-readmitting patients. A common strategy that can be used to curb rates of readmissions is improving the discharge plan and making sure patients have adhered to all appointments. In most cases, after an individual is allowed to go home, they do not care to follow up on the doctor’s appointments.

Poor patient engagement and education is yet another barrier to effective care transitions and hospital readmission reduction initiatives (Warchol et al., 2019). Sometimes patients are not in their discharge process, which leads to a high probability of returning to the hospital soon. Patients can be more engaged by educating them about follow-up care. During the hospitalization, there should be some time set aside for patient questions where patients are informed of their treatment options. With this, there is an assurance that a patient will be more cooperative in preventing readmission. Other than having a transparent discharge planning process, deploying a nurse-driven medication reconciliation can also go a long way in reducing the probability of readmission.

The cooperation of the various individuals involved in healthcare will significantly reduce the number of patients readmitted. The fact that readmissions impact a hospital and the community’s financial stability makes reducing it a critical objective for hospital managers. The issue is not new, even though it has recently become a priority for CMS. However, while strategizing on reducing the percentage of hospital readmissions, it is worthwhile to remember not to violate the freedom of patients or prevent them from seeking medical care

References

Friebel, R. (2018, April 27). What do changes in readmission rates tell us about quality of care in the NHS? Retrieved from https://www.health.org.uk/blogs/what-do-changes-in-readmission-rates-tell-us-about-quality-of-care-in-the-nhs

Warchol, S. J., Monestime, J. P., & Mayer, R. W. (2019). Strategies to Reduce Hospital Readmission Rates in a Non-Medicaid-Expansion State. Perspectives in Health Information Management16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669363/

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