Each year, the Illinois Hospital Association (IHA) recognizes hospitals across the state with Quality Excellence Achievement Awards for innovative quality interventions and best practices designed to transform healthcare. A 29-member panel of nationally recognized quality improvement experts evaluated nearly 100 applications for IHA’s 2014 Quality Excellence Achievement Awards, and selected Alexian Brothers Health System (ABHS) in the healthcare system category.
ABHS received the award for an initiative that has significantly reduced 30-day readmission rates for Medicare patients discharged after hospital stays for treatment of heart attacks, congestive heart failure and pneumonia. During the last three years, ABHS has implemented a variety of quality interventions to reduce readmissions among such patients at its two Illinois acute-care hospitals, Alexian Brothers Medical Center (ABMC) in Elk Grove Village and St. Alexius Medical Center in Hoffman Estates. ABHS has surpassed its initial 10 percent readmissions reduction goal by achieving a 14.5 percent readmission rate – down from 20 percent.
“This achievement shows the kind of patient benefit that can result from sustained teamwork and collaboration within a health system and between a health system and its community partners,” said Diana Woytko, ABHS Vice President of Patient Safety and Quality.
Thanks to the efforts of ABHS and other Ascension hospitals focusing on readmission reductions, Ascension Health reduced hospital readmissions by 15.9 percent in the fiscal year ended June 30, 2014. This achievement allowed 5,502 patients to spend nights at home with their families and avoid unnecessary costs, rather than spending more time in the hospital.
The collaborative efforts of the ABHS readmissions team, composed of physicians and medical professionals from ABMC and St. Alexius, led to implementation of a variety of strategies, such as:
- Assignment of a pharmacist to oversee reconciliation of medications upon admission as well as patient/family medication education throughout their acute care stay; and final reconciliation and education upon discharge and subsequent follow-up with patient after discharge.
- Social worker assessment to identify social needs upon admission, working with patient/family to resolve prior to discharge; follow-up post discharge to ensure that the plan is meeting the patient/family needs, and intervening if needs are identified.
- Fine-tuning processes for early identification of patients at high risk for readmission; for understanding patients’ wishes regarding advanced care; and for educating patients and their families about medication requirements and other aspects of patients’ discharge plans.
- Following up with patients to ensure they visit their physician within 48 to 72 hours after discharge.
- Collaborating with skilled-nursing facilities to implement best practices for helping patients avoid readmission after being discharged to the facilities.
- Enhancing care for patients discharged to their homes. ABHS is working to improve transitions of care between its hospitals and home health agencies and is arranging for special evaluations of discharged patients who are not eligible for home health services or decline them. ABHS also is providing those patients with special electronic monitoring equipment such as blood-pressure and weight-tracking devices.
Reducing readmissions is a key objective of the Affordable Care Act of 2010. Under the law, hospitals now face reductions in Medicare reimbursements if their readmission rates for heart attack, congestive heart failure and pneumonia patients fall short of government standards.
“Our responsibility is no longer just to stabilize or cure patients,” said Carol Pfeifer, Director of Quality Improvement for the Acute-Care Ministries of ABHS. “We have to think globally beyond the walls of the hospital and take responsibility for this patient population.” She accepted the award on behalf of ABHS at IHA’s Leadership Summit on Sept. 30 in Lombard, Illinois.
The ABHS readmissions initiative will be featured in IHA’s Quality Excellence Achievement Awards Compendium, which will include all award entries with project descriptions. The compendium, expected to appear in early 2015, is shared electronically and garners national exposure on the American Hospital Association’s Hospitals in Pursuit of Excellence website.
