Most clinicians feel systems and procedures for preventing hospital readmissions ineffective

More than nine out of ten clinicians believe that reducing readmissions is an important topic, but few have the resources at hand to tackle it, according to a new study from QuantiaMD®, the leading mobile and online physician community, and the Society of Hospital Medicine (SHM). The study surveyed 1,013 clinicians and found that though 94% of them feel reducing readmissions is an important topic, 71% believe their organizations' current systems and procedures for preventing readmissions among high-risk patient populations are only somewhat or not effective. Most clinicians also feel that their organizations don't provide adequate training and education on the topic.

“Hospital's have focused on length of stay as a key metric, and this has lead some to fear that increased readmissions would be an unintended consequence if systems were not in place to make transitions from hospital to home as seamless as possible”

More than half (54%) of clinicians queried believed that the current training and educational opportunities at their organizations did not adequately focus on reducing readmissions. When asked about which topics they would like more information, top responses included post-discharge follow-up care, condition-specific interventions and discharge communication. Respondents most frequently treated patients presenting with the following conditions - which are most commonly associated with hospital readmissions: heart failure; COPD; pneumonia; coronary artery disease; and psychiatric illness.

"There are a number of discharge issues that can impact whether a patient is safely transitioned from the hospital to home," said Mark V. Williams, MD, FACP, FHM, Professor & Chief of the Division of Hospital Medicine at Northwestern University Feinberg School of Medicine and Principal Investigator, Project BOOST. "We need to optimize care in the hospital, of course, but we also need to educate patients and caregivers about their condition, ensure that pending tests and studies are completed, and then get those results into the hands of the patient's primary care provider. All of this can occur with optimized communication with patients' outpatient physicians. They want this, and they deserve it."

Please view Dr. Williams' presentation, "The Dangers of Hospital Discharge", on the QuantiaMD website at http://my.quantiamd.com/player/pxtmgne. The presentation, hosted by QuantiaMD, underscores many of the practical issues related to reducing readmissions, including follow-up visits and the role of chronic conditions.

Those same issues are addressed by SHM's Project BOOST, a cutting edge program that incorporates mentorship and a resource kit developed by Dr. Williams and other experts in the field. More than 60 hospitals across the country have implemented Project BOOST and SHM is currently recruiting more sites. For more information about Project BOOST, and to explore ways hospitals can become Project BOOST participants, visit www.hospitalmedicine.org/boost.

The importance of working to reduce unnecessary readmissions was highlighted in an April 2, 2009 New England Journal of Medicine study, co-authored by Dr. Williams, that found that nearly one in five Medicare beneficiaries were re-hospitalized within 30 days, and, unplanned Medicare readmissions cost the federal government $17.4 billion. Further pushing this issue to the forefront is the fact that under a new federal health care law, the Centers for Medicare & Medicaid Services will begin penalizing hospitals with higher than expected rates of readmissions starting in 2013.

"Hospital's have focused on length of stay as a key metric, and this has lead some to fear that increased readmissions would be an unintended consequence if systems were not in place to make transitions from hospital to home as seamless as possible," said Michael Paskavitz, Editor in Chief of QuantiaMD. "Now, healthcare reform legislation will penalize hospitals with high readmission rates, and this survey clearly shows that physicians agree that readmissions are a problem for their patients, and they want to contribute to a solution. But they currently just don't have the education, tools and resources they need to participate in a systems solution that spans the care continuum."

Reducing avoidable hospital readmissions represents a unique opportunity for positively affecting health care costs while increasing the quality of patient care. According to a 2007 Congressional report by the Medicare Payment Advisory Commission, 75% of hospital readmissions could be avoided with increased efforts designed to prevent unnecessary rehospitalizations.