Unplanned hospital readmissions have long been a costly problem for the healthcare industry, both in human and monetary terms. According to the NCDR ACTION Registry, a study of nearly 87,000 patient records showed that 27.5% of patients were readmitted within 90 days of discharge from the hospital. Medicare has estimated the average cost of readmission at $15,200 per patient and yet another study pegs the median proportion of readmissions that are
avoidable at more than 27%.
Hospitals, not surprisingly, are now expected to share in the cost of unplanned readmissions. In 2012, Medicare began to penalize hospitals for what are deemed to be excessive readmission rates. Nearly half of all U.S. hospitals are penalized by Medicare each year for excessive readmissions at a cost of more than $200,000 per hospital on average. It’s safe to say that unplanned readmissions are now officially on the radar for healthcare systems and insurers alike.
Researchers have worked tirelessly to determine the causes of unplanned hospital readmissions in an effort to get ahead of this problem. Interestingly, provider/patient communication is an issue that keeps rising to the fore.
Randomized trials have shown that up to 75% of readmissions could be prevented, in part through better patient education. A study published in The Journal of the American Medical Association (JAMA) focused specifically on “potentially preventable readmissions.” Of the four main factors identified in the study, two were directly related to inadequate communication. A third study confirmed that poorly communicated instructions at the point of discharge were a significant problem. Of the patients surveyed:
• 24% did not fully understand their follow-up treatment plan.
• 42% did not receive a complete set of discharge instructions.
• 64% were unclear on what issues would warrant a return trip to the emergency room.
The Agency for Healthcare Research and Quality (AHRQ) created the IDEAL Discharge Planning Implementation Handbook as a way of reducing adverse events and preventable hospital readmissions. The handbook defines the five “IDEAL” elements of an effective patient discharge process as follows:
• I = Include the patient and family as full partners in the discharge planning process.
• D = Discuss with the patient and family ways to prevent problems at home.
• E = Educate the patient and family in plain language about the patient’s condition, the discharge process and next steps.
• A = Assess how well the doctors and nurses have explained the above and ask the patient and family members present to repeat or “teach back” the instructions.
• L = Listen to and honor the patient’s and family’s goals, preferences and concerns.
Appropriately enough, the final steps in the IDEAL handbook occur on the day of discharge. Nearly all involve the hand-off of paper-based communications from the hospital to the patient, including:
• Give written discharge instructions to the patient and family.
• Review a reconciled medication list with the patient and family.
• Write down the follow-up appointment times for the patient and family.
• Write the name, position and phone number of the hospital contact if a problem is encountered after discharge.
And therein lies a key tool in the effort to reduce unplanned hospital readmissions – the patient discharge folder. Much more than just ink on paper, patient discharge folders and the documents they include have the power to dramatically improve the patient’s understanding and retention of information vital to their long-term recovery. Discharge instructions, appointment dates and times, medication schedules, important phone numbers and more are all gathered in one place for repeated reference by the patient and their family members. In doing so, patient discharge folders can help measurably improve outcomes for patients while reducing healthcare costs industry-wide.
Taylor Healthcare and its legacy companies have been providing communication solutions to the healthcare industry for more than 100 years. Today, this includes a wide assortment of printed items including labels, wristbands, forms, signage systems and much more – such as patient discharge folders. We offer a variety of custom-printed patient discharge folder styles ranging from simple two-pocket folders to expandable portfolios capable of holding pens, notepads and up to 100 sheets of paper. Contact a Taylor Healthcare representative to learn more.