McKnight's reports about a study in The Journal of the American Medical Association documents how post-acute providers are successfully reducing hospital readmissions by communicating and collaborating more closely with hospitals and other healthcare providers. The research, funded by CMS, studied 14 communities where hospitals collaborated with post-acute providers to improve care transitions, with a 5.7% drop in readmissions withing 30 days. It also noted benefits from nursing homes applying the Interventions to Reduce Acute Care Transfers (INTERACT) model.
This coincides with another study by Columbia University Medical Center (also published in The Journal of the American Medical Association) that "long-term care providers have to treat patients holistically rather than zero in on a specific illness," because Medicare rehospitalizations were so frequently caused conditions different from the original admission.
“Strategies that are specific to particular diseases or periods may only address a fraction of patients at risk for rehospitalization," the study concluded.
Great conversation! Interact and other safe transitions programs are changing the way many SNFs and Rehab Centers approach discharge planning. Many centers have successfully added these components and self-care management teaching programs for patients & families to support safe discharge and decrease traumatic exacerbations and re-hospitalizations.
I see these as an opportunity for not only the patient but for skilled nursing centers as well.
Posted by: hynes.associates@aol.com | 01/25/2013 at 01:04 PM