With U.S. 30-day readmissions penalties reaching record levels, hospitals are looking for innovative new ways to effectively cut patient readmissions. A recent Mayo Clinic study published in the journal JAMA Internal Medicine reviewed the existing body of research around readmission prevention programs. Here’s a breakdown of what they found.
What Researchers Investigated
This study was a meta-analysis that looked at the results of 47 randomized clinical trials conducted between 1990 and 2013. These trials studied a variety of patient care and discharge transition interventions designed to reduce all-cause or unplanned adult hospital readmissions within 30 days of discharge. The Mayo researchers statistically analyzed all the combined study data to determine which interventions were most effective.
What the Findings Revealed
The good news is that all of the interventions included in the meta-analysis were found to have a beneficial effect on the risk of 30-day readmissions, reducing rates by an overall average of 20%. These included:
- Patient telephone follow-up after discharge
- Medication counseling by pharmacists
- Self-management education programs
- Tele-homecare and remote patient monitoring
- Specialized discharge teams and discharge planners
- Nurse case managers
- Outpatient education and support
- Mandatory home visits
- Use of care coordinators
- Individual exercise-based care plans
- Standardized discharge packages
- Use of transition coaches
- Integrated personal health records
- Computer-based education
- Peer mentors
- Use of special discharge software
- Family caregiver training
- Patient hotlines
- The most effective interventions were those that were focused on improving patient self-care skills for their transition from hospital to home. The researchers also found that interventions that considered patient context (i.e., cultural, language, literacy, and social differences) and accounted for the realities of home life following discharge were more successful in reducing readmissions.
What It Means for Your Hospital
Many U.S. hospitals are already taking a hard look at their discharge processes as part of a comprehensive readmission reduction program. Your patient education efforts should focus on giving your patients the self-care skills they need to succeed at home. For high-risk populations like the elderly and those with chronic illnesses, customized education and coordinated discharge planning is particularly critical.
To learn more about this study, watch this video interview with lead author, Dr. Aaron Leppin.