Improving the patient’s hospital experience relies heavily on two things: not making people sicker while they’re in the hospital and not welcoming them back within 30 days of discharge. With these goals in mind, the U.S. Department of Health and Human Services (HHS) announced in May 2014 that there was an 8 percent reduction in the national readmission rate between January 2012 and December 2013. That represents an estimated 150,000 fewer readmissions among Medicare beneficiaries.
Meanwhile, HHS says there was a 9 percent decrease nationally in hospital-acquired conditions during 2011 and 2012. Some $4 billion was saved over these years thanks to reductions in adverse drug events, falls, infections and other hospital-induced conditions. In human terms, that meant nearly 15,000 deaths were prevented and 560,000 patient injuries were avoided.
It’s important progress, and state-level best practices are at the core. In Tennessee, for example, the state’s hospital association, in partnership with a major health insurer, launched the Tennessee Center for Patient Safety in 2007 as a support for hospitals, and the results came quickly. The 126 institutions participating in the center’s programs reduced hospital-acquired infections and surgical complications to the tune of $18 million from 2008 to 2011.
One key area in Tennessee has been the reduction of costly catheter-related urinary tract infections, which was addressed by implementing a nurse-led protocol for removing catheters that are no longer necessary. Hospitals using the protocol have seen infection rates drop by as much as 20 percent. Other initiatives have included investigating every patient fall and hiring liaisons to help with heart failure patients.
Florida has also been on track to reduce readmissions for the last several years. The state’s hospitals were able to cut readmissions in five areas—heart attack, heart failure, pneumonia, hip fracture and bypass surgery—by more than 11 percent from late 2008 to late 2010, saving $12 million in the process. The Collaborative on Reducing Admissions helps reps from 107 Florida hospitals share ideas about how to keep patients from making return visits.
Florida’s success has come from solutions that are customized for the community. After discovering that the hospital-to-home transition wasn’t going well for many of those who were readmitted, one hospital implemented a house-calls program to follow up on newly released patients. The goal: to make sure they understand how to take their medications and when to follow up with their primary care physicians. Other local solutions have included a visiting nurse program and a medication delivery program.
Another key to improved patient care nationwide has been the growing number of public reports on hospital performance. Websites such Medicare’s Hospital Compare and Leapfrog Group allow patients to do simple searches by hospital name, state or zip code and find rates of readmission and types of hospital-acquired conditions. Leapfrog even has a hospital safety score.
To date, more than 3,700 hospitals nationwide have joined the Partnerships for Patients, an initiative of the Centers for Medicare and Medicaid Services that looked at 2010 data on hospital-acquired conditions and complications during transition. CMS set a goal of reducing in-hospital conditions by 40 percent and transition complications by 20 percent through the end of last year. The 2013 data aren’t in yet, but with goals like these set by the federal government, and examples being set by leading states, the move toward better in-patient and after-discharge care is only picking up steam.Learn how LDS Hospital – Intermountain Healthcare, Ellis Hospital and The Nebraska Medical Center utilized vendor credentialing to improve patient safety. Download these 3 Case Studies for improving patient safety.


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