Welcome to the October Issue of
HIIN The Know
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HSAG HIIN is focused on the Partnership for Patients (PfP) HIIN national goal of reducing readmissions for all causes by 12 percent by March 2020, and is focusing efforts on patients and families as the center of care.
Although the focus has shifted to patient-centered care and the implications of readmissions on the patient, hospitals continue to monitor regulatory updates and the evolution of the readmission outcomes. On September 11,
the Centers for Medicare & Medicaid Services (CMS) released guidelines
for fiscal year 2020 based on hospitals performance between July 1, 2015, through June 30, 2018, for payments starting on October 1, 2019. The goal of the
hospital readmissions reduction program (HRRP)
is to incentivize hospitals to share accountability for improving communication across the healthcare continuum, as well as prepare patients and families for post-acute discharge by empowering them to speak up, ask questions, and engage their providers. The
publicly reported measures
for 30-day risk-standardized unplanned
readmission
include condition-specific for acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure (HF), pneumonia and procedure-specific for coronary artery bypass graft (CABG) and total hip arthroplasty (THA) and/or total knee arthroplasty (TKA). Additionally, there is a new hybrid
hospital-wide all-cause readmissions (HWR)
measure
with claims and electronic health record data included in the hospital inpatient quality reporting (IQR) program, which is voluntary for the first two years (July 1, 2021, to June 30, 2023) and then becomes mandatory starting July 1, 2023. This hybrid measure will replace the claims-based measure once it becomes mandatory (July 1, 2023).
“Partnering” is the real goal, with the expectation of improved care coordination as a positive result. Patients and families, as well as post-acute providers, are your partners. Senate Bill 1152, enacted in California this year,
ensures hospitals work with area services providers to secure wrap-around services for homeless patients at discharge
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In October 2018, the CMS Skilled Nursing Facility (SNF) avoidable readmission penalty began, as part of the SNF Value-Based Purchasing (VBP) program, encouraging SNFs to partner with the hospitals in their services area.
Let HSAG HIIN help identify the best tools and strategies to fit your needs so together we can reach another threshold of harm reduction in reducing readmissions. Please reach out to your Quality Advisor to discuss how to review your readmissions data reports, identify disparities, and focus your care coordination efforts to the communities you serve.
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HSAG HIIN Hospitals' Current Readmissions Performance
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The information below indicates the HSAG HIIN current readmissions performance. About one half of HSAG HIIN hospitals are worsening in this clinical topic. The following DRG codes account for almost 40 percent of readmissions.
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Improvement Tools and Resources
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HSAG HIIN Readmissions
Field Guide
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HSAG HIIN Readmissions Reduction Tool
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HSAG HIIN Readmissions
Fishbone Diagram
This diagram contains readmissions information for providers, patients, and families on improvement strategies and specific readmission resources for successful post-hospital transition.
Click here to view the diagram.
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HSAG HIIN Readmissions Strategy Tree
This strategy tree will ensure healthcare facility processes are in place to prepare patient, family, and post-acute care partners for successful post-hospital transition.
Click here to view the strategy tree.
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AHRQ Health Literacy Tools
These tools from the Agency for Healthcare Research and Quality (AHRQ) allow direct comparison of health literacy for English and Spanish speakers. Use these tools for research, clinical, or program planning purposes.
Click here to view AHRQ health literacy tools.
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The Data Advantage Corner
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Reminder—Hospital Readmissions and Healthcare-Associated Infection (HAI) Reports
Available!
The hospital readmissions report provides a summary of your hospital’s Medicare Fee-for-Service (FFS) readmissions data through Q1 2019 and provides overall and stratified readmission rates—allowing your hospital to identify key areas of focus. The HAI report provides an overall summary of HAI measures and an update on your hospital’s National Healthcare Safety Network (NHSN) data from Q2 2018 through Q1 2019. To find your hospital’s readmission and HAI reports, please log in to the
HSAG HIIN Secure Data Portal
and select the Reports tab.
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Upcoming Events and Education
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Health Equity Organizational Assessment (HEOA) Office Hours
Friday, October 25, 2019
9 to 10 a.m. PT
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Tell us about a best practice or noteworthy story you would like to share with the HSAG HIIN community. What you do makes a difference, so please share!
One Organization's Readmissions Improvement Best Practices
St. Rose Hospital in Hayward, California, has created improvement strategies that can help reduce your hospital's readmissions.
Click here
to view the strategies and best practices used by St. Rose Hospital.
The Transition-of-Care Team Model Overview
Covenant Plainview Hospital in Plainview, Texas, shares its transition-of-care team model in an effort to reduce readmissions.
Click here
to view their strategies and best practices.
The Readmission Reduction "Get-Stuff-Done" Approach
Covenant Medical Center in Lubbock, Texas, shares its "get-stuff-done" approach that can help your hospital's readmissions.
Click here
to view their team's strategies and best practices.
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