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South Carolina Cuts Readmission Rates Through Cooperation, Education

State-wide learning collaborative gets results

Approximately 39 million inpatient hospital discharges occur in the U.S. each year, with estimated total costs for care of nearly $387 billion. Hospital discharge marks a period of increased risk for new or worsening symptoms, adverse events, and hospital readmission. Almost one in five Medicare patients is readmitted to a hospital within 30 days, and this rate has increased over the past decades. Accordingly, hospital readmissions have become a subject of increasing scrutiny.

South Carolina health care providers have significantly reduced hospital readmissions and improved the quality of transitional care through a statewide initiative, according to an article posted on the FierceHealthcare website. The program was described in Population Health Management.

Researchers analyzed data from acute care hospitals (ACHs) in South Carolina that participated in the Preventing Avoidable Readmissions Together (PART) initiative, a statewide quality-improvement learning collaborative. Under PART, leadership teams recruited from member organizations and hospitals designed programs divided into five parts over 2 years. Fifty-nine of 64 (92%) ACHs and nine of 10 (90%) hospital systems participated in collaborative events.

After an initial statewide learning session, hospitals engaged in a 3-month planning phase dedicated to forming multidisciplinary teams, to mapping hospital discharge processes, and to performing root-cause analyses using tools and techniques provided by PART experts. The subsequent 6-month action period focused on implementing transitional records and patient education. A second action phase focused on discharge summary timeliness and quality, and the third focused on improving timely hospital discharge follow-up appointments and post-discharge patient contact. Each subsequent phase included the addition of further care-transition strategies.

Program content for each period addressed conditions that carry a high risk of readmission, including congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and acute myocardial infarction (AMI).

Between 2011 (the last full year before the implementation of PART) and 2013 (the first full year after implementation) compared with earlier trends (2009–2011), a higher proportion of hospitals had decreases in 30-day readmission rates for AMI (55.6% vs. 30.4%, P = 0.01), CHF (54.2% vs. 31.7%, P = 0.09), and COPD (41.7% vs. 33.3%, P = 0.83).

The authors concluded that “PART successfully engaged the majority of acute care facilities in one state [South Carolina] to harmonize and accelerate adoption of evidence-based care transitions strategies.”

Despite these gains in readmission reduction, as well as similar progress nationwide, recent research indicates that hospitals that improve their readmission rates may still face penalties, FierceHealthFinance previously reported.

Sources: FierceHealthcare; July 8, 2015; and Population Health Management; June 23, 2015.


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