Hospitals in pursuit of excellence

Small Tests, Big Results

Small tests of change can give hospitals momentum and show early progress in improvement projects. Lakeview Regional Medical Center, a 172-bed hospital in Covington, La., focused on collaborating, improving coordination and conducting small tests of change to reduce its 30-day readmissions rate. An interdisciplinary team—including the chief nursing officer, hospital medical director, case manager, nursing directors, core measure specialists and representatives from the quality and social services departments—examined the hospital’s readmissions data and processes and reviewed best practices. Then the core measure specialists interviewed every patient treated for congestive heart failure, pneumonia and acute myocardial infarction. This feedback from patients helped the project team identify opportunities and interventions. Changes included communicating at discharge with the primary care physician; scheduling patients’ follow-up appointments at discharge; and using a standard set of questions for follow-up phone calls to all CHF, pneumonia and AMI patients. Strong support from senior leadership was key as well as collaboration with nursing homes and other post-acute providers. Lakeview Regional reduced readmissions for not only its targeted group but also all patients: From 2012–2014, the hospital’s all-cause, all-payers, 30-day readmission rate decreased from 11 percent to 8 percent. Lakeview Regional continues conducting more tests of change, including adding a discharge assessment for high-risk patients. In late 2013, it also began collaborating with three other area hospitals to participate in the CMS Community-based Care Transitions Program, focusing on high-risk Medicare patients.

For more information, contact Kelo McKay, director, quality, risk and infection control, at Kelo.Mckay@hcahealthcare.com. To read the complete case study, access the AHA/HRET HEN website at www.hret-hen.org and click on “Preventable Readmissions/Case Studies.”

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