For hospitals struggling to reduce their 30-day readmission rates, there is no reason to go it alone.
Networking with others who share the same readmission reduction strategy is one of the primary benefits of participating in the Avoiding Readmissions through Collaboration, or ARC, says Liz Malcolm, program officer with the San Francisco-based Gordon and Betty Moore Foundation.
The foundation supports the collaborative of 21 San Francisco Bay-area hospitals, which have averted approximately 4,000 hospitalizations and saved an estimated $39 million since 2010. The hospitals, which use various care models to reduce readmissions, look to one another for inspiration and information.
"A hospital that uses Project RED visits another hospital that is using Project RED, or a hospital that is using Project BOOST visits another BOOST hospital," Malcolm says, referring to the Re-Engineered Discharge (RED) strategy developed at Boston University Medical Center and the BOOST strategy promoted by the Society of Hospital Medicine. "And when a new hospital comes on board, they use the network to quickly get up to speed on their care model."
Regardless of the care model used, most hospitals use certain techniques, such as post-discharge calls or teach-back patient education, to support it. ARC hospitals participate in educational sessions to learn from one another.
"So how do you do a post-discharge call very well? How do you get the right phone number in the first place? How do you get through to the patient? How do you make sure that the call is of high value?" says Pat Teske, implementation officer with Cynosure Health, the group leading the collaborative. "One hospital can benefit from another hospital's experiences — how they set up their program and what they have learned."
Other collaborations work in different ways. In suburban Chicago, Ingalls Memorial Hospital is seeing its 30-day readmissions fall by partnering with three competing hospitals through the federal government's Community-based Care Transitions Program. In this initiative, Catholic Charities of the Archdiocese of Chicago provides care transition services — help with medications, in-home care, patient coaching and follow-up visits with a nurse or social worker — to Medicare patients discharged from any of the four hospitals.
Ingalls organized the multihospital effort because Medicare's Readmissions Reduction Program penalizes a hospital for 30-day readmissions, regardless of where the patient is readmitted.
"We have to put the whole competitive landscape together here so that none of us are dinged on this," says Andrew Stefo, senior vice president and CFO. "What's good for one is good for everybody, so we started reaching out to our peer hospitals in the marketplace."