Reports identify positive healthcare outcomes and innovative initiatives related to older adult hospital readmissions and length of stay
NICHE (Nurses Improving Care for Healthsystem Elders) announces the release of two NICHE Hospitals Reports that identify positive outcomes and innovative initiatives at NICHE designated healthcare organizations related to older adult readmissions and length of stay (LOS). The reports are part of a series published by NICHE that can be downloaded at: http://nicheprogram.org/niche_hospitals_report_series.
According to the Centers for Medicare & Medicaid Services (CMS), a readmission is defined as an admission to a hospital within 30 days of a discharge from the same or another hospital. The Affordable Care Act added a section to the Social Security Act establishing the Hospital Readmissions Reduction Program that requires CMS to reduce payments to hospitals with excess readmissions. According to the CMS, 78% of hospitals are financially penalized for readmissions.
Hospitals and their initiative results related to readmissions included in the reporting are:
• Mercy Health Saint Mary’s Hospital, Grand Rapids, Mich. – Surveys conducted by the hospital showed a 42% reduction in readmission rates of chronic obstructive pulmonary disease patients, a 16% reduction in readmission rates of pneumonia patients, and a 31% reduction in readmission rates of myocardial infarction patients.
• Palmetto Health, Columbia, S.C. – Readmissions went from a high of 24.9% in 2013 to 11.5% in 2015.
• John C. Lincoln North Mountain Hospital, Phoenix, Ariz. – Over a ten-month period, none of the 17 congestive heart failure patients transferred to participating skilled nursing facilities were readmitted to the hospital.
• Bassett Healthcare Network, Little Falls (N.Y.) Hospital – Readmission rates declined from 11.3% to 3.44%.
• South County Hospital Healthcare System, Wakefield, R.I. – Readmission rates declined from 22% in 2013 to 13% in 2014.
Length of Stay Report
According to the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost And Utilization Project, in 2012 for adults over the age of 65 there were 12.7 million hospital stays in the United States, with an average LOS of 5.2 days. Length of stay reduction is a key driver for improvement. One of the intents of value-based purchasing is to reduce lengthy hospital stays.
Hospitals and their initiative results related to LOS included in the reporting are:
• Covenant Health, Chicago, Ill. – The hospital realized a 49.6% reduction in LOS.
• Carilion Roanoke (Va.) Memorial Hospital – Older adult patients had a shorter mean LOS (4.6 days compared to 5.3 days).
• ProMedica Toledo (Ohio) Hospital – This hospital reduced LOS from 5.54 to 3.94 days and saved $600,000.
• Hunterdon Medical Center, Flemington, N.J. – This hospital realized a 17% decrease in LOS for intensive care unit patients with delirium.
• PinnacleHealth, Harrisburg, Pa.– LOS declined from 3.52 days to 2.75 days for older adult patients.
The initial report in the Hospitals Report series provides a summary of outcomes and initiatives from many care categories and healthcare settings. Earlier topical reports deal with delirium, dementia, function, operationalizing NICHE, safety, and transitions.