Hospital Readmission Rates Among The Elderly Essay

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

McLaughlin, C.P., & Kaluzny, A.D. (2006). Continuous Quality Improvement in Health Care, Third Edition, Jones & Bartlett Publishers, Sudbury, MA.

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

The Affordable Care Act was enacted to improve health care and to lower health care cost in America. The ACA developed different strategies to meet these goals called the “pay for performance” programs. These strategies are aimed at the different providers to improve quality care. The strategy that I selected is the “Hospital Readmissions Reduction Program” this program/strategy is also known as the HRRP and was begun in October of 2012. HRRP is aimed at hospitals and penalizes hospitals that have a high 30 day readmission rate. The penalties are assessed and based on a number of comparisons, those such as, performance, patient demographics, comorbidities and frailty.

In a world of budget cut and layoffs, medical corporations face new and different challenges in addition to helping and healing patients. I used to work as a medical biller in a physician’s office for five years and I experienced how difficult for the health care providers to get reimbursed. The government and the insurance companies have been limiting the budget towards the health care services. This action also affects the hospitals greatly because Centers for Medicare & Medicaid Services (CMS) and some policymakers have requested the hospitals to reduce the

This project will focus on a hospital located in the upper Midwest. The focus of the project will be on Medicare readmissions at Henry Ford West Bloomfield Hospital (HFWBH). .

For health care organizations quality data collection is an essential tool used for data collection. The information produced from the data assists the health care organization in other functions such as effective ways to manage and perform decision making for the organization, this includes the strategic planning process. Quality improvement is the method of assessing processes and provides the information necessary to improve services. All of this together allows the health care organization to become a high producing system of

What factors contribute to multiple Chronic Obstructive admissions and how can the number of readmissions within 30 days be reduced? The Affordable Care Act added section 1886 to the Social Security Act. This section created the Hospital Readmission Reduction Program (HRRP). The purpose of HRRP is to reduce hospital spending and improve quality of care (Sjoding & Colin, 2014). HRRP requires Centers for Medicare and Medicaid Services (CMS) to reduce, or penalize, hospitals receiving payments from CMS for excessive admission of several chronic diseases, taking affect in October 2012 (CMS, 2018). Chronic Obstructive Pulmonary Disease was added in 2015 as one of these conditions.

Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital

In my current position, the Hospital Readmission Reduction program plays a pivotal role in my job. I am a part of a new initiative in conjunction with NexusMontgomery. “This program aims to provide care management intervention that will reduce overall hospital costs and reduce hospital admissions and readmissions in Montgomery county Maryland” (Regional Trans, 2015, p. 1). Funding is provided from The Center for Medicare and Medicaid Services. The program aims to significantly reduce the number of residents in Montgomery County with hospital admissions and readmissions. The targeted population are seniors 65 years and older. The client must have Medicare and reside in an eligible Montgomery county zip code. The program will reduce hospital

The Center for Medicare and Medicaid Services (CMS) have proposed policies that will penalize healthcare organizations for the increasing readmission rate related to patients who has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD). This readmission policy is part of the CMS Hospital Readmission Reduction Program (HRRP) which was enacted to further address the diminishing quality of health care services and to curb the rising cost of health care services by providing financial incentives to healthcare organization in order to promote gravitation toward Accountable Care Organizations (ACO) or Managed Care Organization (MCO). The main objective of levying reimbursement penalties on healthcare organizations is to move away from the fee-for-service method of reimbursement toward a patient-centric, and disease management approach where healthcare services are coordinated not just in the acute phase of disease, but also in the chronic of phase disease.

The hospital readmission (HR) may be regarded as an indicator of the quality of hospital care and, indirectly, of primary care. Some factors may foster HR, such as low quality of supportive care, early discharge, lack of treatment adherence on the part of users and their families, age, absence of specific guidance and post-discharge follow-up, as well as socioeconomic and cultural conditions. Therefore, in order to perform a resolute care, one needs to know the profile of admissions and of HR, thereby enhancing the planning and the implementation of strategies. In order to raise the aforementioned questions, this study had the purpose of analyzing the profile of readmissions of children treated in the pediatric sector of the Regional Hospital in Ceilândia (HRC) in March, April and May 2015. This

As the nations focus continues to be on cost and quality of medical care rendered, the push for standardization persist. Care in Anytown USA should mimic the care rendered in the most elite medical centers in the country. This is our duty to the patients that we serve. The organizations that were listed by Mr. Druse strive to universalize the care that every patient receives ensuring quality and safety for all. NDNQI participation allows nursing and organizations to stay current with the trends and avoid commonly seen errors that occur in healthcare. The IOM uses information from clinical research and standard of practice to 'fuel' their interventions and initiatives (Dunton, 2008). Quality improvement is driven by evidence- based practice and allows organizations to measure themselves against national comparative data (Dunton, 2008).

To ensure the best health care provided to older adults, nurses need to apply the nursing process to all their patients to reduce their hospitalization and help them live better lives. This also provides the health care provider all the information needed to plan their care. L. Lilley, S. Collins, and J. Snyder (2013) explain the importance of lifespan considerations with elderly patients, “More than 80% of patients taking eight or more drugs have one or more chronic illnesses. More complicated medication regimes predispose elderly patients to self-medication errors, especially those with reduced visual acuity and manual dexterity.” (p. 43) Considering our patients age of being over 65, special considerations are needed

For years, healthcare costs have continued to increase in the United States and policymakers are constantly trying to find ways to reduce spending. According to reports, in 2011, about $900 billion out of the $2.6 trillion annual health care spending was wasteful spending. In the following year, there was a reported $690 billion wasted annually on healthcare. This wasteful spending is attributed to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody et al., 2016). Policymakers on the federal and state level have developed and implemented several programs, some varying state to state, to help reduce wasteful spending while improving quality of care.