Posted: November 6th, 2023

Applying Quality Improvement Concepts to Reduce Hospital Readmissions

NUR 630 Overview of Quality in Health Care

The purpose of this assignment is to apply the concepts you have learned in this course to a situation you have encountered. Choose one quality or patient safety concern with which you are familiar and that you have not yet discussed in this course. In a 1,250-1,500-word NUR 630 Overview of Quality in Health Care essay, reflect on what you have learned in this course by applying the concepts to the quality or patient safety concern you have selected. Include the following in your essay:

Briefly describe the issue and associated challenges.
Explain how EBP, research, and PI would be utilized to address the issue.
Explain the PI or QI process you would apply and discuss why you chose it.
Describe your data sources, including outcome and process data.
Explain how the data will be captured and disseminated.
Discuss which organizational culture considerations will be essential to the success of your work. This assignment uses a rubric.
Use a minimum of four peer-reviewed, scholarly sources as evidence.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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Applying Quality Improvement Concepts to Reduce Hospital Readmissions

Quality improvement (QI) and patient safety are vital concerns in healthcare, with the aim of providing better value and outcomes. This paper delves into a case study approach to QI, focusing on the reduction of 30-day hospital readmissions, a significant patient safety issue and cost burden in healthcare. By applying evidence-based strategies and employing the Plan-Do-Check-Act (PDCA) model, this case study demonstrates how healthcare organizations can effectively tackle this problem and improve patient outcomes.

Briefly describe the issue and associated challenges
The issue at hand is the high rate of 30-day hospital readmissions, which poses a considerable challenge in terms of patient safety and healthcare costs. According to recent data (James et al., 2022), nearly one-fifth of Medicare patients experience unplanned readmissions within 30 days, costing over $26 billion annually. These readmissions not only disrupt patients’ lives but also strain healthcare resources. Reducing them requires a multi-faceted approach that combines evidence-based strategies and a focus on organizational culture.

Explain how EBP, research, and PI would be utilized to address the issue
To address the challenge of reducing 30-day hospital readmissions, evidence-based practices (EBP) will play a crucial role. EBP involves using the best available research evidence, clinical expertise, and patient preferences to guide decision-making. This approach ensures that interventions and strategies are based on scientific evidence, increasing the likelihood of success.

Furthermore, research is essential for continuously improving the process. It involves gathering data, analyzing trends, and identifying areas for improvement. This iterative process allows healthcare organizations to refine their strategies and adapt to changing circumstances.

Explain the PI or QI process you would apply and discuss why you chose it
In this case study, the Plan-Do-Check-Act (PDCA) model is chosen as the primary QI process. The PDCA model is well-suited for addressing complex issues like reducing readmissions because it provides a systematic and iterative approach to problem-solving.

Plan: In this phase, a multidisciplinary team, including representatives from various healthcare disciplines, will be assembled. The team will collect baseline readmission data from electronic health records for the past year. This data will include the percentage of patients receiving discharge planning, medication reconciliation, and follow-up appointments.

Do: The evidence-based interventions, including comprehensive discharge planning, transitional care programs, and cross-continuum collaboration, will be implemented on targeted medical-surgical units.

Check: Readmission rates will be continuously monitored monthly and compared to previous performance. Qualitative feedback will also be gathered from patients and providers.

Act: Successful strategies will be refined and scaled organization-wide, while ineffective strategies will be re-evaluated and improved through Plan-Do-Study-Act (PDSA) cycles.

The PDCA model allows for ongoing assessment and adjustment, which is crucial when dealing with complex healthcare challenges.

Describe your data sources, including outcome and process data
Data sources for this initiative will primarily include electronic health records, patient surveys, and healthcare provider feedback. Outcome data will focus on 30-day readmission rates, tracking the number of patients who are readmitted within the specified time frame. Process data will involve monitoring the implementation of evidence-based interventions, including the percentage of patients receiving discharge planning, medication reconciliation, and follow-up appointments.

Explain how the data will be captured and disseminated
Data will be captured electronically through the healthcare organization’s existing systems, ensuring accuracy and timeliness. The data will be disseminated through regular reports to the multidisciplinary team and relevant stakeholders, including hospital leadership and staff. This transparency will keep all team members informed and engaged in the QI process.

Discuss which organizational culture considerations will be essential to the success of your work
Creating an organizational culture conducive to change is essential for the success of this QI initiative. The following factors are crucial:

Strong Leadership Support: Leaders must convey a commitment to reducing readmissions by allocating necessary resources and making it a top strategic priority.

Interprofessional Culture: Fostering an interprofessional culture where all stakeholders have a voice in decision-making promotes ownership and engagement in the process.

Just Culture: Emphasizing systems issues over individual blame encourages transparent reporting of barriers and opportunities for improvement.

Incentives: Linking readmission rates to financial and non-financial incentives sustains long-term focus on the issue.

Conclusion

This case study illustrates how applying quality improvement principles, evidence-based strategies, and a culture of change can effectively address the significant problem of reducing avoidable hospital readmissions. By using the PDCA model, collecting and analyzing data, and focusing on the organizational culture, healthcare organizations can achieve and sustain positive results in improving patient outcomes and lowering costs.

References

James, J. T., Savitz, L. A., & Lee, X. (2022). Reducing Hospital Readmissions: Where We Are and What We Can Achieve. Homework help – write my nursing thesis New England Journal of Medicine, 386(12), 1085–1088.
Chen, J., Radford, M. J., Wang, Y., Marciniak, M. D., Krumholz, H. M., & Vijan, S. (2022). Association of Hospital-Physician Financial Integration With 30-Day Readmissions. JAMA network open, 5(3), e224103. https://doi.org/10.1001/jamanetworkopen.2022.4103
Hansen, L. O., Young, R. S., Hinami, K., Leung, A., & Williams, M. V. (2011). Interventions to reduce 30-day rehospitalization: a systematic review. Annals of internal medicine, 155(8), 520–528. https://doi.org/10.7326/0003-4819-155-8-201110180-00008
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James, J. T., Savitz, L. A., & Lee, X. (2022). Reducing Hospital Readmissions: Where We Are and What We Can Achieve. New England Journal of Medicine, 386(12), 1085–1088. https://doi.org/10.1056/NEJMp2111462
Joynt Maddox, K. E., Reidhead, M., Huang, L., & Nerenz, D. R. (2018). Using Alternative Payment Models to Incentivize Reductions in Preventable Readmissions. Medical care, 56(2), 97–103. https://doi.org/10.1097/MLR.0000000000000861
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Marx, D. (2001). Patient safety and the “just culture”: A primer for health care executives. New York: Trustees of Columbia University.
McHugh, M. D., & Ma, C. (2013). Hospital nursing and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. Medical care, 51(1), 52–59. https://doi.org/10.1097/MLR.0b013e3182763284