REDUCING HOSPITAL READMISSION RATES IN SKILLED-NURSING FACILITIES

Abstract

Hospital readmission and outpatient emergency department visits within 30 days of index admission to a skilled nursing facility (SNF) is a widespread issue caused by a combination of procedural, technical, and cultural contributors. The most commonly cited reasons for unplanned hospital readmissions are inadequate care planning at time of discharge, lack of coordination between hospital and SNF, and acute illness at the time of discharge. The purpose of this EBP project was to reduce hospital readmission rates and outpatient emergency department visits at Palolo Chinese Home (PCH) by implementing an evidence-based progressive mobility protocol during initial admission. Methods The clinical question was, “How can we reduce the number of patients who are readmitted to the hospital or sent to the emergency department shortly after being admitted to a skilled-nursing facility? This was an EBP project which utilized a progressive mobility protocol for all new residents admitted to PCH and staff education on progressive mobility benefits and guidelines. Retrospective data was collected after a 3-month implementation period, comparing the rates of hospital readmission and outpatient emergency department visits between pre- and post-intervention periods using audits of monthly quality assurance data from PCH and official data from The Centers for Medicare and Medicaid Services (CMS). Results The progressive mobility program reduced 30-day hospital readmissions from 13% in August 2019 to 4% in December 2019. The number of emergency department visits also decreased from four in the previous quarter to only one in the last quarter of 2019.