Reduce readmissions

A significant proportion of patients (3% - 11%) return to hospital within 28 days because complications have arisen as a consequence of their health at the time of admission, their operation, they have acquired an infection during their hospital stay, they have dislocated their joint, the joint has become infected, or rehabilitation has not progressed as planned.  There is evidence that patients that are readmitted have a longer length of stay than for first admissions and that providers with lower than average lengths of stay for first admission have higher readmission rates. Reducing readmission rates can reduce average length of stay, whereas reducing average length of stay without tackling readmission rates may have the medium term impact of increasing length of stay.

Readmission rates can be reduced by tackling the key causes through:

  • health assessment, planning and improvement
  • better surgery: examining the variation in readmission rates of individual surgeons
  • reducing hospital associated infection
  • ensuring that mobilisation begins within 24 hours of surgery, that post discharge exercise regimes are in place and understood by the patient, and that the patients home, family and carers are organised to provide support for 14 days beyond discharge

How to do this in scenario generator

Reduce length of stay without tackling causes of readmission The model has an inverse link between length of stay and readmission rates and will automatically increase readmission rates if length of stay is reduced unless this link is disabled in the Input Manager
Tackle root causes of readmissions: Disable link between length of stay and readmission rate then:
- health assessment See checklist for Establishing Patient Needs/Wants Surgery
- better surgery Reduce surgical complication rate in Stage 6 of the pathway
- reduce hospital associated infection Reduce HAI rate in stage 6 of the pathway
 - rehabilitation and mobilisation  Increase percentage of patients who route down Stage 4 of the pathway with immediate rehabilitation (5 - 7 days length of stay), review the percentage of patients going to post discharge therapy or assessment, reduce both complication and readmission rates in stage 6