How to Reduce Hospital Readmissions and Improve Patient Outcomes

Hospital readmission is a significant quality and cost issue for medical systems. Patients who come back to the hospital soon after discharge are an indication that the care continuum was broken and, in most cases, results in poor patient outcomes. 

Unplanned readmissions are not only a strain on resources but also affect the patient experience and cause increasing healthcare expenses. It is important to focus on effective hospital readmission reduction measures in order to provide high-quality patient-centered care and bring permanent changes in health.

The initial step to successful hospital readmission prevention is to understand the underlying causes of readmissions. Hospitals can greatly reduce the number of return visits and guarantee the health of patients lasts longer by applying specific interventions at both ends, which are admission and post-discharge.

Common Causes of Hospital Readmissions

Healthcare providers should initially determine the main causes and remedies of readmissions to adequately deal with this challenge. Particular causes of readmission differ depending on the targeted patient population and condition.

1. Poor Discharge Planning – A rushed or boilerplate discharge process that does not individualize the directions to the patient and his/her literacy level or living conditions.

2. Lack of Patient Education – Patients who do not fully learn about their illness, medication, and lifestyle changes that they have to make.

3. Ineffective Medication Reconciliation – Misinterpretation, subsidy, or misconception with various changes made in the prescription, which occurred during the hospital stay.

4. Absence of Patient Follow-Up Care – Fails to attend or misses scheduled or needed appointments with primary care physicians or specialists post-discharge.

5. Uncontrolled Chronic Conditions – Exacerbation of the chronic illness due to poor adherence to self-management or lack of treatment in time, e.g., heart failure, COPD, diabetes, etc.

6. Socioeconomic Barriers – It can be related to the lack of transportation to a follow-up appointment, being unable to afford medication, or support at home.

Effective Readmissions Reduction Strategies

1. Enhancing the Discharge Planning

Best practices of discharge planning must commence early in the patient’s hospital stay, rather than several hours before discharge. This is inclusive of an in-depth evaluation of the clinical health of the patient, his functional capacity, social circle, as well as his health literacy.

The patient is provided with all the required durable medical equipment and home services before leaving the facility. The primary care provider of the patient is informed instantly, and a follow-up appointment is scheduled, preferably within a period of seven days of discharge.

Medication reconciliation is discussed extensively with the patient and/or caregiver, and a clear description of any new or modified prescriptions is provided.

2. Improving the Patient Education

One of the key challenges to recovery is health literacy. Hospital readmission depends on effective patient education. 

The clinicians need to employ the technique requiring the patient to describe their ailment, the drug regimen, and the warning signs using their own language instead of handing out some written materials. 

This ensures that one gets the knowledge, and areas that require more elaboration are determined. Education must also be on the particular red flags of deteriorating conditions and who to call before visiting the emergency department.

Related: Can Remote Patient Monitoring Cut Readmissions by 50%?

3. Leveraging Remote Patient Monitoring

Remote Patient Monitoring could become a game-changer in high-risk patients, especially those with a condition treated with the help of chronic disease management programs. 

RPM systems can enable the clinical teams to monitor vital signs like blood pressure, blood glucose, and weight at home. Early detection of clinical worsening, such as an abrupt increase in weight in a patient with heart failure, and quick intervention – typically via phone call or internet visit – prevents an emergency room visit or readmission.

4. Post-Acute Care Co-ordination

The key to a smooth transition is post-acute care coordination. This requires excellent and timely communication between the hospital and subsequent care providers, such as skilled nursing facilities, home health organizations, and outpatient clinics.

A complicated non-face-to-face service that the member of the clinical staff offers to the patient over the two business days after discharge.

Required face-to-face visit with the discharging or treating physician, or other qualified health professional, within 7 or 14 days of discharge. Continue medication treatment and follow-up until the follow-up appointment.

Technology Role in Readmission Prevention 

Electronic Health Records – A complete EHR system enables all care team members, including hospitalists, nurses, case managers, and outpatient providers, to share the same and current information about patients to enable free communication and minimize mistakes.

Predictive Analytics – Hospitals are moving to more advanced analytics solutions to predict the patients who are at the greatest risk of readmission during admission. 

These algorithms take into account clinical and socioeconomic status and history of previous admission, something that allows the care team to focus more intensive patient follow-up attention and resources on those who need it more.

Telehealth – Virtual check-ins and video visits provide an easy method that clinicians can use to make post-discharge follow-ups, particularly to patients who have mobility or transportation challenges. 

The access of patients to care is a significant aspect of readmission prevention that is enhanced most dramatically by telehealth services.

Vozo Patient Portal Solution

Vozo patient portal software provides a comprehensive solution to help healthcare providers achieve clinical, financial, and operational excellence through a powerful patient portal.

Our exceptional Patient Portal Software will allow:

• Have complete access to patients’ medical records digitally
• Our cost-effective subscription plan helps healthcare practices at all levels.
• The Vozo patient portal can effortlessly be integrated and implemented with any EHR system to increase productivity.
• Vozo’s Patient Portal respects users’ privacy and safeguards health-related records and personal information.
• 24/7 availability to support you with your needs and requirements.
• By understanding your unique needs for your specialty healthcare practice, we will customize Vozo’s patient portal for a seamless workflow.

Patients can request appointments, access health records and lab results, and even pay bills online with the help of a patient portal, which creates a personal touch with you always.

Leverage the Vozo Patient Portal for Better Healthcare Solutions.