Jefferson Health

Readmissions

The return of patients to the hospital within a month of discharge is a persistent, yet sometimes preventable issue in American healthcare. Often, those people who are hospitalized for conditions such as heart failure, heart attacks or pneumonia can avoid being readmitted when they follow certain steps such as scheduling follow-up physician appointments and filling prescriptions.

Hospitals can help reduce readmissions by following certain best practices such as providing follow-up care assistance and working with patients and family members to ensure discharge instructions are clear and understood.

Heart Failure Readmissions

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Heart Failure Readmissions

Heart failure is a progressive chronic illness that can lead to fluid building up in the arms and legs, lungs, and other parts of the body. Managing heart failure well with appropriate treatments, medications and self-care can slow the progression of the disease and reduce the need for hospital care and readmissions.

What We are Doing to Reduce Our Heart Failure Readmission Rates

  • Enhanced patient education materials – print and video – are provided to all patients.
  • Pharmacists educate patients and families about medication while in the hospital.
  • Schedule a follow-up doctor's appointment before the patient is discharged from the hospital.
  • A member of the staff calls patients several times after discharge to review their discharge instructions, medications and follow-up appointments.

Pneumonia Readmissions

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Pneumonia Readmissions Legend

Pneumonia is a lung infection caused by bacteria or virus that can result in illnesses that range in severity. Pneumonia is the second most common diagnosis of hospitalized Medicare beneficiaries aged 65 and above.

A key to reducing hospital readmissions for pneumonia patients is effective communications with patients, family members and other caregivers that include clear medication and discharge instructions and follow-up appointments which are all elements of our care coordination program for all patients diagnosed with pneumonia.

What We are Doing to Reduce Our Pneumonia Readmission Rates

  • Provide patient enhanced pneumonia related educational materials.
  • Pharmacists provide patients and their families with medication education during hospital stay.
  • Hospital staff call patients several times after discharge to review discharge instructions, medications and check on follow-up appointments.

Heart Attack (AMI) Readmissions

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AMI Readmissions Legend

More than 700,000 Americans have a heart attack or acute myocardial infarction (AMI) each year, including 525,000 first time heart attack patients and 190,000 people who have had a previous heart attack.

Quick interventions including the use of angioplasty and coronary stents to reopen clogged cardiac arteries enable many heart attack patients to return to normal activities quickly, but risk modification and adherence to medication protocols are necessary to prevent second cardiac event.

What We are Doing to Reduce Our Heart Attack Readmission Rates

  • A follow-up doctor's appointment is scheduled before the patient is discharged from the hospital.
  • Hospital staff call patients several times after discharge to review discharge instructions, medications and to check on follow-up appointments.
  • Pharmacists provide patients and their families with medication education during hospital stay.
  • Provide patient enhanced heart related educational materials.