Effects of Implementing a Health Team Communication Redesign on Hospital Readmissions Within 30 Days

Background and Rationale Poor communication between health team members can interfere with timely, coordinated preparation for hospital discharge. Research on daily bedside interprofessional health team rounds and nursing bedside shift handoff reports provides evidence that these strategies can improve communication. Aims To improve health team communication and collaboration about hospital discharge; improve patient experience of discharge measured by patient‐reported quality of discharge teaching, readiness for discharge, and postdischarge coping difficulty; and reduce readmissions and emergency department (ED) visits postdischarge. Methods A two‐sample pre‐ and postintervention design provided baseline data for redesign of health team communication processes and comparison data for evaluation of the new process’ impact. Health team members (n = 105 [pre], n = 95 [post]) from two surgical units of an academic medical center in the midwestern United States provided data on discharge‐related communication and collaboration. Patients (n = 413 [pre], n = 191 [post]) provided data on their discharge experience (quality of discharge teaching, readiness for discharge, postdischarge coping difficulty) and outcomes (readmissions, ED visits). Chi‐square and t tests were used for unadjusted pre‐ and postintervention comparisons. Logistic regression of readmissions with a matched pre‐ and postintervention sample included adjustments for patient characteristics and hospitalization factors. Results Readmissions decreased from 18% to 12% (p \u3c .001); ED visits decreased from 4.4% to 1.5% (p \u3c .001). Changes in health team communication and collaboration and patients’ experience of discharge were minimal. Discussion The targeted outcomes of readmission and ED visits improved after the health team communication process redesign. The process indicators did not improve; potential explanations include unmeasured hospital and unit discharge, and other care process changes during the study timeframe. Linking Evidence to Practice Evidence from daily interprofessional team bedside rounding and bedside shift report studies was translated into a redesign of health team communication for discharge. These strategies support readmission reduction efforts

Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting

An interprofessional, intercultural, immersive short-term study abroad program: public health and service systems in rome

The purpose of this paper is to describe a short-term study abroad program that exposes engineering and nursing undergraduate students from the United States and Italy to an intercultural and interprofessional immersion experience. Faculty from Purdue University and Sapienza Università di Roma collaborated to design a technical program that demonstrates the complementary nature of engineering and public health in the service sector, with Rome as an integral component of the program. Specifically, the intersection of topics including systems, reliability, process flow, maintenance management, and public health are covered through online lectures, in-class activities and case study discussions, field experiences, and assessments. Herein, administrative issues such as student recruitment, selection, and preparation are elucidated. Additionally, the pedagogical approach used to ensure constructive alignment among the program goals, the intended learning outcomes, and the teaching and learning activities is described. Finally, examples of learning outcomes resulting from this alignment are provided

Implementing Risk Tools to Prevent Hospital Readmission

Implementing Risk Tools to Prevent Hospital Readmission Tara O’Connor Abstract Background: Readmission reduction is one of the most important opportunities for reducing cost in today’s health care system. Global Aim: To operationalize risk tools to reduce hospital readmissions by 5 percent by the end of 2017. Project Aim: To develop new transitions program (TP) processes that operationalizes the risk tools and ensures 70 percent of all readmission risk score patients referred receive a post discharge phone call within 48 hours, and are assessed for their risk of medication management issues as part of their initial assessment, by August 1st, 2017. Setting: The TP provides short term case management for patients transitioning home from hospital and other level of care. Quality Gap: An evidence-based means of identifying patients at risk for readmission and a standardized process for assessing medication management issues was previously lacking. Evidence: Intervention demonstrated in clinical trial to reduce readmissions requires timely post discharge follow-up, assessment of and interventions for medication management issues, education on the plan of care, and interventions that address the social barriers of health maintenance and promote patients’ and their caregivers’ capacity for self-management. Results: Through clinical leadership, utilization of the Institute for Healthcare Improvement’s (IHIs) model for improvement, and interdisciplinary collaboration, the TP team has developed new processes that preliminary data suggests are accomplishing the project aim

Scaling Up: Bringing the Transitional Care Model Into the Mainstream

Describes features of an innovative care management intervention to facilitate elderly, chronically ill patients' transitions among providers and settings; the adopting organization; and the external environment that affect its translation into practice