Hf Readmissions

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.”

In 2011, there were approximately 3.3 million readmissions to hospitals, raising healthcare costs and negatively impacting patient health. Two important contributors are discharge planning and education. Many patients do not receive enough of either, and are sent home misinformed about their diagnosis and medications. In order to decrease readmissions, hospitals should utilize interactive patient systems to educate patients while they are in the hospital. This will increase patient knowledge of their diagnosis, as well as make it easier for nurses to go over discharge teachings with the patient. This gives

Your hospital will be penalized if you get readmitted within 30 days because of the chronic disease mismanagement. The Affordable care act (ACA) has changed the perspective of chronic disease management of hospitals, shifting their focus from treating the conditions to deciding ways to prevent them. Under ACA, hospitals will be penalized or rewarded depending upon their performance on 30-day readmissions, infection control and patient satisfaction levels (1). Government is playing his role to reduce the burden of chronic diseases in society but being a responsible citizen, do we realize the intensity of situation and the economic instability it is causing?

Early rehospitalizations of patients in various disease states have been well studied in recent years. Research in this area has increased since the Centers for Medicare & Medicaid Services (CMS) made readmissions within thirty (30) days a major quality indicator for health care organizations. These admits consume a considerable amount of health care costs and interventions are needed that are aimed at reducing risks associated with rehospitalization (Hain, Tappen, Diaz, & Ouslander, 2012). Early readmissions in those with decompensated cirrhosis are costly, partially preventable, and linked to worse patient outcomes (Volk, Tocco, Bazick, Rakowski, & Lok, 2012). Developing specific disease oriented interventions can help decrease morbidity

Congestive heart failure is a growing chronic condition in the United States that accounts for over one million hospitalizations and is responsible for 27% of patients with heart failure on Medicare are readmitted with 30 days of discharge (Hines, Yu & Randall, 2010). The intensity of the disease process poses a financial strain on both the patient and the payers, especially Medicare, as 10 per 1000 population are 65 years or older and therefore a Medicare beneficiary (Mozaffarian et al., 2015). Consequently, in order to gain control over this chronic disease and its cost burden, the government and policy makers have shifted the responsibility to the health care facilities through the creation of policies that affect hospital reimbursement based on readmission rates. As a member of the quality team at my facility, the Hospital Readmissions Reduction Program deeply impacts my practice and encourages the hospital as a whole to focus on improving multidisciplinary collaboration in pursuit of quality patient care, resulting in better outcomes and decreased readmissions.

emergency readmissions and better quality of life for older adults at risk of hospital readmission: a randomized controlled trial to determine the effectiveness of a 24-week exercise and telephone follow-up program. Journal Of The American Geriatrics Society, 57(3), 395-402. doi:http://dx.doi.org/10.1111/j.1532-5415.2009.02138.x

Hospital discharge has been defined as “a systemic problem that can be characterized as a dangerous situation in which latent conditions exist such that sharp end individuals are set up to fail” (Anthony et al., 2005). Understanding this process is flawed warrants an investigation for a change in practice. Research has explored a variety of interventions that address reducing 30-day readmissions such as post-discharge phone calls, RED toolkit, BOOST toolkit, transition coaches, and home visits after discharge. Despite these tools, 30-day readmission rates among the older adult population continue to be a challenging issue.

Good job on your project so far. Management of chronic illnesses is necessary to reduce readmissions. A major contributor of health care cost is high numbers of hospital readmissions, especially for people with chronic illness such as diabetes. Post discharge interventions such as telephone reminders by trained individual who asked patients are they taking their medication? Educating patients about treatment plan, how to detect warning signs, monitoring of blood glucose and self-management (2014).

The need to reduce the 30 day mental health readmission rate at St. Luke’s Hospital is not a new idea. St. Luke’s has a departmental goal of reducing the 30 day readmission rate on the mental health unit. The 30 readmission rate is currently 10.2% on 3W. The 3W 30 day readmission rate has been calculated by counting every admission and transfer to the unit for a particular month and dividing it by the list of patients who have been readmitted from that month within 30 days. The 3W readmission rate of 10.2% is higher than the national average of 9% (AHRQ, 2015). The 3W interprofessional team has identified the need to reduce readmission rates. The mental providers are all experienced with many years of practice. Alternatively the registered

The reconciliation should be used in every transition in care, where the new medication is prescribed and old mediations are rewritten. The accuracy of the list can prevent many drug effects and interactions; therefore it is important to ensure proper documentation and communication at all levels of care. Also, many errors occur when doctors fail to write out necessary orders such as, “resume pre-op medication.” The use of this “resume pre-op medication” has been prohibited by the Joint Commission due to the many complications it can produce including increasing the chances of adverse effects. Furthermore, it has been discovered that most discharged patients have been found to have insufficient knowledge regarding their medications upon returning home (Joint Commission, 2006). Medical reconciliation provides the patient with crucial information regarding the dosage, route, therapeutic effect, and reason for administration.

Holistic care includes a wide range of approaches, including medication, education, communication, self-help, and complementary treatment” (Zamanzadeh, Jasemi, Valizadeh, Keogh, & Taleghani, 2015, p. 214). To promote healing, I must address my patient's socioeconomic status, culture, religion, and psychological levels as contributing factors to their illness. For example, when my patient comes in with diabetic ketoacidosis, I must stop and ask why are they suffering from this illness. Could my patient afford his or her glucose monitor or insulin? Do they have any cultural or religious beliefs that prevent them from taking their medication as prescribed? What is their mental capacity? Were they properly educated about diabetes? I must be able to address all these questions, which sometimes requires collaboration with other healthcare disciplines in order to provide proper care for my patient. I also understand that family and community support is key for my patients' physical and mental well-being. I witnessed this with my mother while she was in the hospital. When she had a guest come by and visit, she was more willing to work with physical therapy and requested less pain medication. When she returned home, she continued to improve thanks to the help and support of the

In 2010 the ACA was passed, it established a Hospital Readmission Reduction Program. What this program did was to penalize hospitals if a patient gets readmitted for the same condition within 30 days of being discharged. Readmissions are significant because they account for approximately one-third of the nation’s health costs. When hospitals use a patient-centered discharge process, the patients are then able to reconcile their medications, follow-up with community-based providers, and self-manage their diseases and treatments. The patient-centered discharge process helps to reduce hospital readmissions. (Cloonan, Wood, & Riley, 2013) By properly educating the patient before discharge it reduces the risk of the patient getting readmitted. Discharging a patient without proper education can result in the patient improperly discontinuing their medication or failing to follow-up with their primary care provider.

People of the Chinese culture have many different beliefs and practices of medicine and healthcare. It is extremely important for nurses to be culturally competent and to be able to understand different practices and beliefs of different cultures to ensure that they are providing the best care and making their patients as comfortable as possible. According to Shih-Yu Lee, ritual is defined as “a social essential collective activity within a culture,” it is also well recognized that culture and ritual plays a fundamental role in “defining, sensing the health and illness, and searching help for problems” (Shih-Yu, Shu-Ling, and Yu-O, 2013). There are many rituals and beliefs of traditional Chinese medicine that are crucial to understand, the

There are many cultures out in the world today that practice beliefs different than those in the United States. America is based off Western Culture and traditional medicine practices which focus on preventative and curative medicine. Most cultures around the world practice folk medicine, which focus more on the person as a whole with remedies and ceremonies rather than medicine and treatment. Even though each one believes in a different practice, all medical professionals should have the knowledge and awareness of each culture’s health beliefs to properly treat their patients in a respectful and kind