Capstone Project Proposal
Reducing of Patient Readmission – Hospital readmission following hospital discharge is a common healthcare challenge across the globe. According to Leppin et al. (2015), 1 in every 5 beneficiaries of Medicare is readmitted within thirty days of discharge in the United States. In this regard, hospital readmission within 30 days has been a significant health challenge and costly phenomena in hospitals. Steventon and Billings (2017) noted that countries with a high prevalence of readmission rates include USA, Germany, England, and Denmark. Considering that these are among the countries with the most developed healthcare systems, then serious interventions ought to be established to reduce the overall health implications. According to Harrison et al. (2011), the elderly and chronically ill patients are at higher risk of readmission. However, the researcher noted that there are few interventions like post-discharge care that can prevent readmissions. Therefore, this research seeks to investigate and propose evidence-based interventions that can be undertaken in healthcare facilities by primary care providers to reduce 30-day readmission rates.
Healthcare facilities in the US and other countries face a challenge of readmission rates thereby creating inefficiency in their primary healthcare goal. Adib-Hajbaghery, Maghaminejad, and Abbasi (2013); Kripalani et al. (2014) established that patient readmission particularly in a short time after discharge from hospital is an indicator that can be used to measure the quality of care. In this regard, this research will seek to investigate the readmission data among in the US healthcare facilities. Data regarding readmission rates will be evaluated as well as the established interventions through a case study analysis, in order to discuss the proposed solutions that can avert the problem. The role of nurses will be specifically evaluated since they are among the primary care providers to the patients.
High readmission rates have significant detrimental effects on the overall quality of care. Specifically, patient care is adversely affected by readmission which has been documented as one of the reasons for increased chronic illnesses. Besides, Harrison et al. (2011) established that financial burden is one of the primary consequences of avoidable re-hospitalization to the patients. In the year 2004, Medicare expenditure in the US that covered unplanned readmission was over $17.4 billion. Besides, patients who seek private care are at risk of running out of funds to access the necessary quality care. In this regard, readmission of discharged patients compromises their overall quality of care.
Nelson and Rosenthal (2015) cited that nurses have a crucial role in post-discharge patient care that has a significant impact on the overall rates of readmission. According to the researcher, nurses should be significantly involved in discharge planning in order to take appropriate measures that can be used to improve the overall patient care. The key interventions were identified to be preparing patient appropriately regarding the post-discharge information. For example, nurses can provide critical information to the home care providers such as family caregivers on their role in discharge planning so that they can be actively engaged (Cosgrove et al., 2013). In this regard, nurses provide an opportunity for care providers to improve post-discharge care.
Numerous pieces of research have established that follow-up activities are critical in reducing post-discharge patient readmission (Dizon & Reinking, 2017). Harrison et al. (2011) established that specialized interventions through telephone calls to the discharged patients by trained nurses regarding support and follow-up steps has a significant impact on reducing readmission rates. In this regard, the evidence-based solution will be advocated in the healthcare organization to reduce the readmission rates and consequently improve the quality of care. Besides, the solution will be backed up by the findings of Nelson and Rosenthal (2015) and Gupta and Fonarow (2018) regarding the role of nurses in post-discharge care. The researchers established that nurses play a critical role in post-discharge follow-up activities. Therefore, nurses will be involved in discharge planning to ensure that all primary caregivers are involved in follow-up activities. Besides, nurses will be involved in communication especially during the transition time to provide necessary information to the patient’s family members.
Reducing Patient Readmission References
Adib-hajbaghery, M., Maghaminejad, F., & Abbasi, A. (2013). The role of contoninous care in reducing readmission for patients with heart failure. Journal of Caring Sciences, 2(4), 255-267. doi: 10.5681/jcs.2013.031
Cosgrove, C., Faldu, S., Moorer, M., Skarzynski, K., Meucci, C., & Wencker, D. (2013). The role of The Heart Failure Bridge Center Infusion Program on reducing all Cause 30 day Readmission Rate in patients with Advanced Heart Failure. Heart & Lung: The Journal of Acute and Critical Care, 42(6), e6-e7. doi: 10.1016/j.hrtlng.2013.10.007
Dizon, M., & Reinking, C. (2017). Reducing Readmissions: Nurse-Driven Interventions in the Transition of Care from the Hospital. Worldviews on Evidence-Based Nursing, 14(6), 432-439. doi: 10.1111/wvn.12260
Gupta, A., & Fonarow, G. (2018). The Hospital Readmissions Reduction Program-learning from failure of a healthcare policy. European Journal of Heart Failure, 20(8), 1169-1174. doi: 10.1002/ejhf.1212
Harrison, P., Hara, P., Pope, J., Young, M., & Rula, E. (2011). The Impact of Postdischarge Telephonic Follow-Up on Hospital Readmissions. Population Health Management, 14(1), 27-32. doi: 10.1089/pop.2009.0076
Kripalani, S., Theobald, C., Anctil, B., & Vasilevskis, E. (2014). Reducing Hospital Readmission Rates: Current Strategies and Future Directions. Annual Review of Medicine, 65(1), 471- 485. doi: 10.1146/annurev-med-022613-090415
Leppin, A., Gionfriddo, M., Kessler, M., Brito, J., Mair, F., & Gallacher, K. et al. (2014). Preventing 30-Day Hospital Readmissions. JAMA Internal Medicine, 174(7), 1095. doi: 10.1001/jamainternmed.2014.1608
Nelson, J., & Rosenthal, L. (2015). How nurses can help reduce hospital readmissions. American Nurse Today, 10(5), 1-10.
Steventon, A., & Billings, J. (2017). Preventing hospital readmissions: the importance of considering ‘impactibility,’ not just predicted risk. BMJ Quality & Safety, 26(10), 782- 785. doi: 10.1136/bmjqs-2017-006629
