Comment – 6304

I have 6 discussions and I want to respond with just one paragraph and a reference and citation.

Quality and patient safety
D 1 (Eman)
hospital readmission rates
COLLAPSE
Reducing hospital readmissions is crucial because it can help patients receive
better treatment while spending less money on it. Patients who are readmitted to
the hospital run a higher risk of acquiring complications and typically end up
staying longer than they would have otherwise. This may result in higher
medical expenses as well as less favorable patient outcomes(Kripalani et al., 2014).
By identifying areas for improvement and putting changes into place to improve
treatment, healthcare quality improvement science can be utilized to help reduce
hospital readmission rates. A methodical, evidence-based approach is used by
quality improvement science to pinpoint issues and put forward remedies. This
can assist in ensuring that modifications made to decrease hospital readmissions
are successful and produce the desired results(Fadol et al., 2019).
Implementing a discharge planning procedure for all patients is one example of a
quality improvement project that may be carried out in the emergency
department environment to decrease hospital readmission rates. For each
patient, this would entail creating a plan for their care when they leave the
hospital and ensuring they have the resources they require to carry it out. By
ensuring that patients have the knowledge and tools they need to take care of
themselves when they leave the hospital, this kind of effort may assist to lower
readmissions(Kripalani et al., 2014).
Teams from the emergency room, discharge planners, and other hospital
employees who would be in charge of carrying out the discharge planning
process would be required to establish, implement, and effectively complete this
project. Together, these teams would create the discharge planning procedure
and make sure it was carried out successfully(Gonçalves-Bradley et al., 2016).
This quality effort aims to enhance patient care and decrease readmissions to
hospitals. Improved patient outcomes and lower healthcare expenditures are two
of the project’s goals. Patients will experience fewer complications and have
shorter stays if hospital readmissions are decreased. This may result in better
patient outcomes and lower medical expenses(Fadol et al., 2019).
Dis 2( Ali)
Hospital Readmission Rate
Introduction
When a patient is admitted to the hospital unexpectedly within a
predetermined time after being released from an earlier or first hospital stay, this is
known as a readmission. Preventable readmissions have turned into a critical
challenge for the healthcare system globally, and hospitals seek care strategies that
reduce the readmission burden. Some countries have developed hospital readmission
reduction policies, and in some cases, these policies impose financial penalties for
hospitals with high readmission rates. (Lahijanian, B., & Alvarado, M. 2021)
Importance of reducing readmission rate
Hospitals have at least two incentives to reduce
readmission rates. Openness through reporting to the public encourages
readmission rates to decline in order to prevent “shaming.” Patients in the
future may be discouraged from selecting hospitals with high readmission
rates. The impact of a hospital’s quality reputation on market share has been
addressed as a driver of profitability, and hospitals may be motivated to lower
their readmission rates in order to avoid earning a negative reputation. In
addition, hospitals that have excessive readmission rates are punished under
the CMS Readmission Reduction Program. For instance, as noted by
Byrnes, readmission penalties in 2017 exceeded a half billion dollars.
Reducing readmission rates is one of the hospitals’ secondary incentives to
avoid these substantial financial penalties. (Upadhyay, S., Stephenson, A. L.,
& Smith, D. G. 2019)
Rising costs of preventable readmissions led the U.S. Centers for
Medicare and Medicaid Services (CMS) to establish the Hospital Readmission
Reduction Program (HRRP). HRRP penalizes CMS payments to hospitals
with high 30-day readmission rates for six conditions: Acute Myocardial
Infarction (AMI), Heart Failure (HF), Pneumonia (PN), Chronic Obstructive
Pulmonary Disease (COPD), Total Hip/Knee Arthroplasty (HK), and Coronary
Artery Bypass Graft (CABG) surgeries. Based on Kaiser Health News (KHN),
approximately 80% of hospitals CMS evaluated for the 2018 Fiscal Year (FY)
faced penalties. (Lahijanian, B., & Alvarado, M. 2021)
How Healthcare quality science improve readmission rate
Medicare and the Department of Veterans Affairs have been using
early hospital readmissions (≤30 days after discharge) as a quality metric
since they were first suggested as a measure of treatment quality in the
1980s. In addition to being used as a quality indicator, readmissions can cost
hospitals money. Hospital Readmission Reduction Program (HRRP):
Hospitals with excessive readmissions can apply for decreased Medicare
payments under this program, which was introduced by the Affordable Care
Act. Readmission reduction is also seen by accountable care organizations
and other financially vulnerable delivery systems as a cost-cutting tactic.
(Pugh, J., et al. 2021)
“A hospital admission that occurs within a specified time frame after
discharge from the first admission” is the definition of a readmission to the
hospital. Readmission rates have been demonstrated to represent aspects of
the caliber of patient care and are regarded as a measure of hospital quality.
The association between readmissions, duration of stay, cost of care, and
death has been covered in earlier research. For example, readmitted patients
have been reported to have a greater in-hospital death rate than nonreadmitted patients. According to some academics, readmissions result in
longer hospital stays and higher resource costs. However, a new study
contends that readmission rates in low-cost hospitals with limited resource
spending were either marginally higher or comparable to those in high-cost
hospitals with greater resource spending. Consequently, by analyzing
readmissions in relation to hospital financial performance, the current study
contributes to this body of research. (Upadhyay, S., Stephenson, A. L., &
Smith, D. G. 2019)
Case Study of quality improvement project in ED
Objective: to shorten severely sick patients’ time being transferred from the
emergency department (ED) to the medical intensive care unit (MICU). (Cohen, R.
I., et al. 2015)
Design: a prospective, observational research conducted in a tertiary academic
medical facility to evaluate quality improvement measures before and after they are
implemented. (Cohen, R. I., et al. 2015)
Interventions: Using a clinical microsystems approach, a group of frontline
healthcare professionals from the ED, MICU, and supporting services sketched out
current practice patterns, identified delays, and tested improvements using the PlanDo-Study-Act method. Measurements and Key Findings The group found several
problems that caused delays. These included delays in identifying and transferring
stable MICU patients as well as inadequate coordination between respiratory
treatment, nursing, and transport services when moving patients from the ED. The
median [interquartile range] of the transfer time was 2.2 (1.4-3.1) hours (P