Reducing Readmissions
Running head: REDUCING READMISSIONS 1
REDUCING READMISSIONS 2
Reducing Readmissions
Student`s Name
Instructor
Institution
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Date
Problem
In patients older than 65 years, do follow up home health visits within 48 hours of discharge compared to no follow-up visit impact 30-day readmission rates?
The general aim of hospital care is restoring the health conditions of all the patients in the best healthcare condition. However, about 20% of the hospital admissions in the US lead to readmission that is unplanned within 30 days after the patient has been discharged, of which a subset can be preventable. Such readmissions can lead to increased costs and potential health risks for patients older than 65 years. Most of the times, the readmission rates are usually used in monitoring quality improvement. The readmissions for the people that are 65 years will help in determining the key reasons for readmissions which includes the inappropriate treatment, premature discharge, and inadequate patient discharge and education planning.
The problem will help in understanding how hospitals that are serving a higher population of patients mostly manage to have higher rates than the national average for readmission, leading to lower Medicare reimbursements. Using the patients who are older than 65 years will help in realizing how the patients from the lower socioeconomic status can have challenges in procuring the follow-up appointments(Mennella& Key, 2018). The problem helps in understanding how readmission rates have decreased. The problem can be used in benchmarking the readmission rates where there are high readmission rates can result in financial penalties. Using the patients that are older than 65 years can help the readmission task force in analyzing hospital data and determining the major diagnoses for the focus by the clinical team in preventing readmissions.
The purpose of this paper is to offer a description of the different findings that will help in finding out how the readmission rates can be reduced.
Description of Findings: Summary
In the article “How do Studies Access the Preventability of Readmissions? A Systematic Review with Narratives Synthesis. BMC Medical Research Methodology,” the key purpose of the study was to offer a comparison between different methods that are used in accessing the preventability of the readiness by means of medical record review(Kneepkens et al., 2019). The study concluded that readmissions could be more likely multifunctional, and it is a shared responsibility to reduce the readmission.
In the article “Case Management: Readmissions,” the purpose of the study was identifying the different reasons in readmission that included inappropriate treatment and premature discharge(Mennella& Key, 2018). The conclusion of the study was that improvement in communication with the post-acute providers is a significant part to reduce readmissions.
Description of Findings: Description
Concepts
There are different concepts that have been studied. One of the key concepts is the multi-layered approach which is necessary when making a positive impact and reducing the hospital readmissions. Most of the hospitals usually have a group of nurses that act as the health care caches for different patients that are at risk. Most of the times, such nurses usually visit the patients are their homes and even follow up with them routinely. The multi-layered approach has been seen to be having some positive impacts on the reduction of readmissions.
Methods
The method used was the stepwise study selection that was conducted using the consensus-based approach. All abstracts were screened by the use of the ley inclusion and exclusion criteria. The references for the already included articles were then assessed, and finally, a detailed inclusion and exclusion criteria were applied.
Participants
The participants of the sample are the patients who are older than 65 years.
Instruments
The critical appraisal tool was used for the study that had been developed by the Cochrane recommendations for narrative data analysis and synthesis. The reliability of the tool has been described where the validated critical appraisal was conducted with the aim of evaluating the reliability and relevance of all articles. The critical appraisal tool was developed in the data synthesis, and the main aim of using the narrative synthesis is the same as the rest of the appraisal tools in avoiding bias.
Implications for Future Work
One of the ways that the study purpose can be answered is through ensuring that the patients have scheduled home health visits within 48 hours of discharge, especially the ones that are older than 65 years. Another way that the study question can be answered is through ensuring there is smooth transitional care where, in addition to the home healthcare, transitional care can help in reducing the hospital readmissions. The study question can be answered by communicating the post-discharge instructions clearly(Mennella& Key, 2018). The findings of the articles do not provide enough evidence for the answers. There is a need for more information concerning transitional care and how it can be beneficial in reducing the readmissions.
There are several things that are needed for the next step in the group. Some of such steps are; What are the causes of readmissions that are modifiable by the hospital? What are the wrong incentives that are provided by the readmission as a quality indicator?
Conclusion
Reduction of readmissions not only to the people older than 65 years but to every other person is a critical thing that should be emphasized. While understanding how the readmission rates can be reduced, it is important to have an understanding on how hospitals that are serving higher population of patients mostly manage to have higher rates than the national average for readmission, leading to lower Medicare reimbursements.
References
Kneepkens, E.-L., Brouwers, C., Singotani, R. G., de Bruijne, M. C., &Karapinar-Çarkit, F. (2019). How do studies assess the preventability of readmissions? A systematic review with narrative synthesis. BMC Medical Research Methodology, 19(1), 128. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1186/s12874-019-0766-0
Mennella, H. D. A.-B., & Key, M. A.-C. A. A. C. (2018). Case management: readmissions. CINAHL Nursing Guide. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T708339&site=eds-live&scope=site be directly applied to the practice
Appendices
Article
Reference
Purpose
Hypothesis
Study Question
Variables
Independent(I)
Dependent(D)
Study Design
Sample
Size and Selection
Data Collection
Methods
Major Findings
1
Kneepkens, E.-L., Brouwers, C., Singotani, R. G., de Bruijne, M. C., &Karapinar-Çarkit, F. (2019). How do studies assess the preventability of readmissions? A systematic review with narrative synthesis. BMC Medical Research Methodology, 19(1), 128
To compare the different methods used to assess the preventability of readiness by means of medical record review.
D- Medical record review.
I-preventability of readiness.
Qualitative
Data search was applied in Pubmed and Embase in December 2016.
Systemic literature search
Readmissions are more likely multifactorial, and the reduction in the rate of readmission is a shared responsibility within the network of care providers and the patents themselves.
2
Mennella, H. D. A.-B., & Key, M. A.-C. A. A. C. (2018). Case management: readmissions. CINAHL Nursing Guide.
To identify the different reasons for readmission, including premature discharge, and inappropriate treatment.
D- Premature discharge and inappropriate treatment.
I-Reasons for readmission.
Qualitative
281 older adults.
Multi-layered approach
Improving communication with the post-acute providers is a critical part of reducing readmissions.
