Hospitals in pursuit of excellence

Re-engineering Reduced Readmissions

By "re-engineering"discharge and enhancing communication, The Chester County Hospital, West Chester, Penn., has halved its readmission rate for congestive heart failure patients. "We think of the discharge process as bundled processes of care beginning with admission," says Carli Meister, R.N., director of customer relations and risk. The 220-bed community hospital uses the Project RED—re-engineered discharge—11-element checklist adopted by the National Quality Forum as safe practice. In addition, TCCH clinical and IT experts worked closely to develop an "After Hospital Care Plan" for patients. The AHCP includes personalized instructions, appointment calendar and medications list, and is delivered by floor nurses using teach-back methodology. Physicians "love the re-engineered discharge" and the AHCP, which they report patients overwhelmingly bring back to follow-up appointments, Meister notes. Also critical to reducing readmissions is a 48-hour post-discharge phone call to patients. TCCH now is focusing on identifying high-risk patients and further reducing the hospital’s readmission rate. By the end of the first quarter of 2012, TCCH's 30-day heart failure readmission rate had fallen to one-third of its 2009 level. For more information, contact Meister at cmeister@cchosp.com.