Managing Readmissions: A Case Study

Improved Essays
The project focused on the development of quantitative tools for managing readmissions. The tool was developed by Rodolfo (myself), and the DNS as part of an efforts to track hospital readmission.
A spreadsheet (Interact) was created for Blair clinical department to track target diagnosis and outcomes. The spreadsheet was able to do it purpose, highlight in red resident that needed to be watch for potential readmission. The spreadsheet is used to identify and quantify the resident’s diagnosis and symptoms that lead to transfer to the hospital in each 30-day period.
The spreadsheet format contains retrospective data for use in evaluating target diagnosis. It includes readmission chains identified by initially admitted diagnosis and discharge

Related Documents

  • Improved Essays

    The program will also allow for the agency to keep track of patient visit listing where, when and what they reason(s) for office or ER visits. For example, if a patient presented in the doctor’s office and had lab work as well diagnostic testing and then return two days later, thus saving time and money by avoiding repeating blood work unless there is a need due to changes in diagnosis. It increases the quality of care as far as waiting time and even possibly can avoid hospital…

    • 735 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    97 (86.58%) of the 104 discharged patients were seen in office with 97 (100%) compliant with discharge medications at the time of first office visit, “(see Appendix G)”. 30 Day Readmissions: 30-day readmission rates were 10 (12.20%) out of 82. Of the 10 patients readmitted within 30 days of discharge, 6 (60%) of those were discharged…

    • 804 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    The readmissions program, created under the Affordable Care Act, initially evaluated how often patients treated for heart attack, heart failure and pneumonia had to return to the hospital within 30 days of discharge. For fiscal 2015 the CMS added treatment for two conditions—chronic obstructive pulmonary disease and total hip and total knee replacements—and the penalty rose to 3%. The CMS data from January to December 2016 revealed that Emory University Hospital in Atlanta, Georgia had higher rates of readmission back to the same hospital than the state and national by 2.72% and 0.98%, respectively. Emory University Hospital was the top discharging hospital by volume in Atlanta for Medicare inpatients, and the third highest in the state. Reasons…

    • 478 Words
    • 2 Pages
    Improved Essays
  • Superior Essays

    The authors also found that it was unclear whether there was a difference in number of patients who were re-hospitalized…

    • 1042 Words
    • 5 Pages
    Superior Essays
  • Decent Essays

    DeBakey Veterans Medical Center Office of Care Coordination-Transfer Center. The project lead will be the only person who will involve with the implementation of the projects. In addition, the standards from the Agency for Healthcare Research Re-Engineer Discharge toolkit will be utilized to facilitate communications among Transfer Center, Fee Basis department, and primary care teams. The interventions are 1) notifying primary care teams with 72 hours of Non-VA care notification regarding Veterans’ admission to ensure adequate post-hospitalization follow-up 2) scanning the Veterans’ Non-VA hospital discharge summaries & medical records into VA’s Computerized Patient Record System within 24 hours of receiving the record from Non-VA facilities. Data regarding the Veterans’ admission diagnoses, Non-VA facilities’ admission dates, dates of discharge, primary insurance, dates of follow-up phone calls from primary care teams, and dates of face-to-face appointments with primary care providers will be collected.…

    • 444 Words
    • 2 Pages
    Decent Essays
  • Improved Essays

    Veterans Access To Care

    • 1242 Words
    • 5 Pages

    The purpose of this memo is to respond the limited patient access problem diagnosis inquiry affecting Veterans at the United States Department of Veterans Affairs (VA). The Veterans Health Administration is the nation’s leading integrated health care system. It consists of 150 Medical Centers, nearly 1,400 Outpatient Clinics, more than 135 Nursing Homes, 278 Veterans Centers, and 48 Domiciliaries. As the nation’s leading integrated health care system and the nation’s second largest cabinet agency, The Veterans Health Administration provides healthcare services to nearly 9 million veterans, including 6 million who seek care regularly (Veterans Health Administration, 2016).…

    • 1242 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    Apr-Dg Research Paper

    • 469 Words
    • 2 Pages

    MS-DRGs: HISTORY: In 1980s, Health Care Financing Administration (HCFA) which is now known as Centers for Medicare and Medicaid Services (CMS) developed a methodology Diagnosis Related Groups (DRGs) under the Inpatient Prospective Payment System (IPPS) to describe all kinds of patient services provided in an acute care hospital. Later, in 1987 3M developed an all patient DRG (AP-DRG) system based on a New York’s hospital reimbursement program for non-Medicare discharges. In 1989, Yale University came up with Refined DRG (RDRG) system to identify the severity of illness incurred to Medicare candidates. Again there was a reform in the system by HCFA which is present CMS in 1990, which includes complications and comorbidities in Medicare DRGs under the category known as…

    • 469 Words
    • 2 Pages
    Improved Essays
  • Improved Essays

    The DRG was developed in 1970’s by Yale University and was adopted since that time to the DRGs is being used in the health care delivery system that is now used to manage as diagnosis identifies to describe the patient care’s diagnosis in an acute care hospital (Bielby, Judy A.,2010). The DRG system’s formation has now become ICD 9 as of this year ICD 10 Codes that offers a systematic way to group patients with similar diagnosis to provide a guideline for pay levels for services rendered. The Capitated system is a fixed amount of money that is set by the payer for each patient. The agreed amount is what the payer has agreed to pay the physician for their services.…

    • 322 Words
    • 2 Pages
    Improved Essays
  • Superior Essays

    Therefore, the adoption and use of electronic health records (EHRs) by healthcare providers, capitalizes on new opportunities to automate processes that improve the quality and safety of care for people after discharge. The current efforts to reduce readmission, encourages the testing of future interventions. Currently, people have been provided opportunities to be active and involved in the care through EHR patient portals. Although this is theoretical, the potential to involve patients in their care improves quality of care (Gurwitz, et…

    • 1329 Words
    • 5 Pages
    Superior Essays
  • Superior Essays

    Avoidable readmissions come at a great cost to patients/residents, healthcare providers, and taxpayers, a $25 billion cost to be exact. This is the estimated amount that avoidable readmissions cost the nation on a yearly basis and is one of the largest contributors to the enormous growth in national health care costs. Readmissions are the result of several difference aspects from incomplete treatment, poor post-acute care, lack of coordination in discharge planning, or even the unavailability of social supports. Recently the Center for Medicare and Medicaid (CMS) began penalizing hospitals for avoidable readmissions as part of the hospital readmission reduction program supported by the Affordable Care Act (ACA). Now that these penalties have become the “law of the land”, CMS is moving onto the next phase of in care continuum, post-acute-care, specifically skilled nursing facilities (SNFs).…

    • 2533 Words
    • 11 Pages
    Superior Essays
  • Improved Essays

    The average length of stay for a patient and its impact on the organizations budget is also a concern. The longer a patient stays, the more likely they are to contract an infection and diminish their health even further. This scenario is not good for anyone. Hospital stays are costly, but in regards to hospital income and budget, we want…

    • 1002 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    PARIHS Scenarios Framework

    • 1082 Words
    • 5 Pages

    A short literature review is included in the background section of the article, and it is relevant to the study. It provides information about the expenses related to readmission and the need of developing the interventions to reduce readmission rates. Poor communication, gaps in follow-up care, discharging patients with pending tests results, and inadequate patient education and discharge instructions have impacted the readmission rate. However, the authors of the article did not include any information about previous studies regarding the benefits of the NP’s involvement in patient care. 6b: The primary sources of information were mostly used in the literature review.…

    • 1082 Words
    • 5 Pages
    Improved Essays
  • Decent Essays

    4. Supporting argumentation for the proposed changes The barriers to action There used to be significant resistance and minimal incentive for preventing readmission in many layers of health care. It is now true that there has been more awareness and attention to the problems and issues regarding readmission to acute-care hospital, regardless of location of care such as ambulatory care or SNF. Therefore, it is also true that numerous researches and papers published to solve this issue by various interventions and programs reflect the significance of problems and emergent attention, especially administrative and management level that is more conscious about the potential financial impact from readmissions.…

    • 733 Words
    • 3 Pages
    Decent Essays
  • Improved Essays

    Trihealth Case Study

    • 849 Words
    • 4 Pages

    Mission, Vision and Values I have worked for TriHealth for over five years as a Registered Nurse. TriHealth is a health care system consisting of two hospitals, several emergency facilities, primary care offices, and a rehabilitation unit that spans the greater Cincinnati area. In that time, I have seen our organization apply for and gain magnet recognition, transition from paper charting to electronic medical records, and change several policies on my unit based on evidence-based research and the input of our shared leadership committee (SLC). Our policies and changes in our culture over the years have been attempts to more reflect the TriHealth mission.…

    • 849 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Patient discharge summaries are documented information explaining important medical recommendations for plan of care. Similarly, Keys To Better Patient Discharge Summaries, identifies “One way to ensure that discharge summaries meet these guidelines: Take advantage of the features of your hospital’s electronic medical records (EHR) system. An EHR that can quickly transmit information about a patient’s hospital stay to a designated primary care provider helps cut back on problems caused by inadequate information after discharge” (White, 2015). Nursing informatics technology is essential for disseminated knowledge to provide patient continuity of…

    • 593 Words
    • 3 Pages
    Improved Essays