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HCMG101 Health Care System

Published : 30-Sep,2021  |  Views : 10

Question:

In an effort to reduce the high costs of health care, health care executives, physicians, and clinical staff establish guidelines to minimize the rates of readmissions for patients. While certain medical conditions may require that patients are readmitted into health care organizations, for less urgent or extensive medical conditions, ensuring that health care service is administered effectively the first time will go a long way in minimizing readmission. From a financial standpoint, patient readmissions constrict health care services, resources, and staff that would otherwise be used to treat new patient cases. From effective health care delivery, a patient who is readmitted may be an indication of poor quality health care delivery, ineffective process workflows, or inefficient patient care.

For this Assignment, review the resources for this week. Reflect on how health care executives might address the board of directors of a health care organization in order to reduce readmissions. Within the context of Medicare reimbursements, how will reducing readmissions benefit the health care organization?

Write a brief to the board of directors explaining how you, as the chief executive of the hospital, would implement strategies to reduce readmissions within the context of Medicare reimbursement. Be specific and provide examples.
 
Be sure to include support from the literature.

 

Answer:

Introduction

Research has indicated that one out five hospitalizations in health care are followed by readmissions. 9 out of 10 of the readmissions are unplanned though 75% of the readmissions can be prevented. The readmissions hurt the health care system as a result of high cost. The readmissions which are avoidable are caused by failures in communication and the entire process in health care. It is found out that almost 80% of the errors in medical care involve miscommunication during handoffs and patient transfers. It indicates that there is a need for accurate, timely and practical communication at discharge to enhance patient care and control wasteful spending.

Reducing readmissions

There is a great need for patients to be accountable for every patient after their discharge to reduce readmissions. Readmissions are costly and currently attracts fines which sum to more than 0.3% of health care base payments made to hospitals in the U.S.A (Hansen, et al. 2011). Health care institutions to engage patients after discharge and provide a care summary of transition. The care transitions to reduce readmissions are discussed below.

Strong and interactive communication

Hospitals should handle the transition of patient situations whether at home, nursing facility or any other location. Communication should not be focused only on clinical information because it is not sufficient for the family, post-acute provider or the patient for the keeping of track. For instance, the family must know the current medications and scheduled follow-up appointments. Information about medical history is necessary because a patient may, for example, skip follow-ups or be non-compliant to medical prescriptions.

Expansion of reach to non-medical providers

Patients should have the requisite resources to complete health care plans. For example, a patient with no support from family may require transportation to pick prescriptions and get to scheduled appointments. Another example is the diabetic and heart failure patients because they need specified nutrition needs (Jerant, et al. 2014). The non-medical providers will supply transportation, cleaning and delivery services to support healthcare gaps. Hospitals should use automated or manual methods to coordinate access to the essential services and resources.

Employ appropriate technology to manage large number of patients

At times when the number of patients is large, hospitals should manage patients using systems which will stratify them according to risk to include the potential for readmission at the points of discharge and the other stages of recovery. An example of higher risk is a patient who misses appointment after 48 hours that a similar patient who has not missed.

Maximize staffing

When patients are managed according to the potential for readmission as identified earlier, compliant patients have lower risks and consequently require a few staff for intervention. Hospitals will be able to highly-tech interventions to high-risk patients and low-tech staff of high-touch to high-risk patients. An example of a 27 years old patient with low risk can be engaged by text messaging without consuming the employees (Hansen, et al. 2011).

Conclusion

In summing up, staffing shortages are always eminent, and the patient situations are becoming complex at inflated rates. Some patients are left vulnerable to avoidable readmissions due to the lack of appropriate staff to coordinate transitions. Technological solutions should be employed to rationalize communication at transitions and optimize resources. It will enable an improved continuity of patient and care outcomes and reduce readmissions and the associated costs.

References

Anthony Jerant, Rahman Azari, Thomas Nesbitt. (2014). Reducing the cost of frequent hospital admissions for congestive heart failure. Medical care, 1234-1245.

Luke Hansen, Young Robert, Hinami Keiki, Alicia Leung, Mark Williams. (2011). Interventions to reduce 30-day rehospitalization: a systematic review. Annals of internal medicine, 520-528.

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