It is no surprise that hospital readmissions have a negative impact on the healthcare system. They affect government budgets and put a strain on facility resources. And of course, they decrease the quality of life for the patients involved.
It is no surprise that hospital readmissions have a negative impact on the healthcare system. They affect government budgets and put a strain on facility resources. And of course, they decrease the quality of life for the patients involved.
Unfortunately, hospital readmissions are not uncommon. Studies show that 1 in 12 Canadians will be readmitted to the hospital within 30 days of being discharged.
People with chronic conditions are usually at a higher risk. This is problematic as chronic disease rates are rising throughout the country.
Luckily, there are methods healthcare professionals can follow to ensure that chronic patients will be kept out of the hospital. It starts with the motivation to improve – demonstrating a commitment to better discharge planning and follow-up care.
In this post, we’ll look at the challenges of attempting to reduce readmissions rates along with potential solutions.
The situation
With our aging population, the amount of people with chronic diseases such as cancer, diabetes, and chronic obstructive pulmonary disease (COPD) is constantly growing. It is not unusual for doctors to see patients who have multiple chronic diseases.
In some ways, care providers are not fully equipped to deal with the complexity of these conditions and the challenges that come along with them.
After a hospitalization, a patient is expected to continue monitoring her chronic conditions. She may struggle to understand the healthcare system and the instructions that follow once she has been discharged. What she shouldn’t have to deal with on top of that, is an unplanned readmission.
And yet, readmission continues to be a perpetual concern for chronic patients.
Research from the Canadian Foundation for Healthcare Improvement has shown that the most common reason patients get readmitted is often related to underlying chronic conditions.
For provincial and federal governments, these costs are not to be overlooked. A study from the Canadian Institute for Health Information found that unplanned readmissions cost the healthcare system $1.8 billion over an eleven-month period. For hospitals, this means your limited resources and time are precious.
Readmissions could occur for a number of reasons – one of the main ones being a rush to discharge patients. Hospital executives have learned this is not effective or sustainable as sending patients home too soon will be costly in the long run.
Unfortunately, the challenges associated with transitioning the patients back to their homes along with the demand for services is taxing. If you are a healthcare leader, it may be time to continue looking for new methods of delivering care.
The problem
Navigating the healthcare system can be difficult for patients. However, as models of care are evolving, healthcare providers can also be just as confused.
When the patients are at home, there is a greater chance for communication between providers to be disrupted. The patients deal with the consequences of this as they require ongoing management and care for their chronic diseases.
When gaps occur, hospital readmissions tend to follow. Discharge planning is critical to avoid this. Focusing on care coordination along with responsibilities for those involved in the care is more important than ever.
There is no solution that will work for every single patient but it helps to take their individual preferences into consideration. Practical, day-to-day details are just as critical.
Patients and those caring for them will likely have many questions once they have been instructed to go home.
What is going to happen now?
When will her next contact with the healthcare system occur?
How does she make the appropriate lifestyle changes?
Pay attention to the state the patient is in when they’re being given this information. Will they remember their self-care instructions? If not, it’s possible she could be readmitted back to the hospital in days.
This is where care coordination is essential. Poor communication during transitions can increase the incidents of hospital readmissions according to the Canadian Medical Protective Association.
When creating a care plan at your facility, you must take everyone’s needs into consideration. Does it encourage collaboration? Is it easily accessible to everyone within the circle of care?
Has a follow up schedule been planned out? Is it sufficient for assessing the patient’s plan adherence, progress, and general wellbeing?
These are just a few important communication questions to ask.
The solution
Understanding how to reduce hospital readmissions is the first step. Making sure those solutions are effective is a whole other challenge. The issue above raises a whole new set of questions.
How will you know the risk of readmission during discharge planning?
Follow-up visits are valuable for making sure the patients needs are being met. But what if there aren’t enough resources to make this happen?
Care providers should be able to update each other in real time. But what if they don’t have the technology and time to do so?
Luckily, innovation is solving some of these problems. Healthcare professionals struggling with the questions above have reason to be optimistic.
First, there are new ways of delivering care now. Home care, while beneficial for the patients, can often lead to broken communication between themselves and their providers. However, provincial initiatives are working to change that.
Take the Ontario Health Links, for example. The Health Links were designed to connect care providers and give the patients with chronic and complex conditions an easier approach at navigating the health system. There’s a lesson to be learned for health executives – improving infrastructure for those using the services lays down a solid foundation for better care.
Technological innovation provides the tools to help practitioners create that higher level of care.
Having a strong circle of care can be key in preventing readmissions. An easy flow of communication and patient information can be more effective than you’d think. Along with care planning, and tool that improves communication amongst multiple people is useful.
An app or program that allows for videoconferencing can be extremely beneficial. These tools allow for easy follow-ups with doctors, nurses or other practitioners without anyone having to travel.
Video can also improve the overall coordination between the care providers. Not only can they see updates about medications, symptom distress, and any other issues. Consultations can be held between experts and caregivers, securely and in real-time.
For example, chronic wounds can cause many hospital readmissions. When a wound care expert is able to coach a home care nurse to provide treatment virtually, the result may be one less chronic patient in a hospital bed.
Of course, not all solutions can offer everything you need. Service providers should look into communication tools and remember the benefits of focusing on care coordination regularly. Once patients are discharged, connecting and updating their circle of care can reduce the chances of them having to be readmitted.
Feature image courtesy of Huffington Post.
