Decreasing the rate of avoidable readmissions to acute care hospitals
Citation: Mileski M, Topinka JB, Lee K, et al. An investigation of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility-to-hospital readmissions: a systematic review. Clinical Interventions in Aging 2017; 12: 213.
What is this? The COVID-19 pandemic is placing a strain on health services. Decreasing the rate of avoidable readmissions from skilled nursing facilities to acute care hospitals can reduce this strain and improve patient outcomes.
In this systematic review, the authors searched for experimental research evaluating the effectiveness of quality improvement (QI) initiatives in reducing avoidable hospital readmissions of patients within 30 days of their original discharge to skilled nursing facilities (SNFs). They restricted their search to articles published in English between 2009 and 2016. Research concerning discharge from SNFs or hospital-to-home settings was excluded. They included 8 retrospective and 2 prospective quasi-experimental studies.
What was found: Sixteen facilitating factors were identified that reduced readmission rates. The most cited facilitating factor was the use of specialized staff.
Thirteen themes were identified that provided barriers to reducing readmissions. The most commonly discussed were issues associated with QI tracking and implementation. Many of these barriers can be overcome by the facilitating factors that were identified.
What’s uncertain: The research mainly relied on smaller retrospective study samples and there was no consistent implementation of QI initiatives to compare.
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