A Multifactorial Intervention Reduces 14 and 30 Day Hospital Readmissions from a Skilled Nursing Facility

2013 ◽  
Vol 14 (3) ◽  
pp. B13
Author(s):  
Emily R. Downing ◽  
Emily R. Downing ◽  
Neal Buddensiek ◽  
Peter Sandgren ◽  
Karen Tomes ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
Day Hospital ◽  
Multifactorial Intervention ◽  
Nursing Facility ◽  
Skilled Nursing

Project ReEngineered Discharge (RED) Lowers Hospital Readmissions of Patients Discharged From a Skilled Nursing Facility

2013 ◽  
Vol 14 (10) ◽  
pp. 736-740 ◽  
Author(s):  
Randi E. Berkowitz ◽  
Zachary Fang ◽  
Benjamin K.I. Helfand ◽  
Richard N. Jones ◽  
Robert Schreiber ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing

A Rapid Recovery Protocol Applied to Total Joint Arthroplasty Reduced Readmissions for Surgical but Not Medical Reasons Over a 5-Year Period

2021 ◽  
pp. 155633162199868
Author(s):  
Justin Turcotte ◽  
Nandakumar Menon ◽  
Jeanne Angeles ◽  
Amina Zaidi ◽  
Paul King ◽  
...  
Keyword(s):  
Total Joint Arthroplasty ◽  
Hospital Readmissions ◽  
Univariate Analysis ◽  
Skilled Nursing Facility ◽  
Joint Arthroplasty ◽  
Rapid Recovery ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Total Knee ◽  
Recovery Protocols

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly performed procedures that are expected to continue increasing in demand. Although they are proven to be safe and effective, emergency room (ER) visits or hospital readmissions within 90 days after these procedures account for more than one-third of the total cost of postacute care. Purpose: We sought to identify changes in reasons for 90-day ER visits and readmissions after total joint arthroplasty (TJA) during a 5-year period over which rapid recovery protocols evolved. Methods: We conducted a retrospective cohort study comparing 1980 patients who had undergone TJA from July 2017 to June 2018 with a previously published cohort of 7466 patients who had undergone TJA from July 2013 to June 2017. All procedures were performed at a single institution. Changes in the proportion of patients returning for medical and surgical reasons were compared using univariate analysis. Results: For patients discharged home, the 2017–2018 cohort showed a significant reduction in the proportion of ER visits due to pain and swelling and wound infection and an increase in visits for medical reasons. This cohort had a higher proportion of readmissions for medical reasons. In patients discharged to a skilled nursing facility (SNF), similar reasons for ER visits were observed across time periods, and a decrease in the proportion of readmissions for wound infections was observed in the 2017–2018 cohort. Falls and nausea, vomiting, or diarrhea increased significantly to account for 9.5% of readmissions each in 2017–2018. Conclusion: The results of a comparison of 2 cohorts demonstrate the heterogeneous and dynamic nature of unplanned return-to-hospital events and the importance of patient support throughout the surgical episode. As we strive toward minimizing ER visits and readmissions after TJA, rapid recovery protocols must continue to evolve to address the complexity of this patient population.

Reducing Hospital Readmissions Through a Skilled Nursing Facility Discharge Intervention: A Pragmatic Trial

2020 ◽  
Vol 21 (4) ◽  
pp. 508-512 ◽  
Author(s):  
Rebekah L. Gardner ◽  
Kimberly Pelland ◽  
Rouba Youssef ◽  
Blake Morphis ◽  
Kathleen Calandra ◽  
...  
Keyword(s):  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
Pragmatic Trial ◽  
Nursing Facility ◽  
Skilled Nursing

Abstract 15301: Skilled Nursing Facilities and 30-day Hospital Readmissions in Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sheila M Manemann ◽  
Alanna M Chamberlain ◽  
Jennifer St. Sauver ◽  
Susan A Weston ◽  
Ruoxiang Jiang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
International Classification Of Diseases ◽  
Revolving Door ◽  
Nursing Facilities ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Classification Of Diseases ◽  
The Impact

Background: Referral to a skilled nursing facility (SNF) should contribute to reducing hospital readmissions; however, a “revolving door” phenomenon after admission to SNF has been hypothesized to drive readmissions. The urgent need to study the impact of SNF on readmissions in heart failure (HF) was recently emphasized, yet this has never been studied in the community. Objectives: To evaluate the association between discharge to SNF and 30-day readmissions in a community cohort of hospitalized incident HF patients. Methods: Olmsted County, MN residents hospitalized with first ever (incident) HF (International Classification of Diseases-9 th Revision code 428) from 1995 through 2010 were identified. HF was validated by Framingham criteria. Patients residing in a SNF prior to hospitalization were excluded from the analysis. Logistic regression was used to examine the association between discharge to SNF and 30-day readmissions. Results: Among 1360 HF patients (mean age 74±14, 47% male), 241(18%) were referred to a SNF. Overall, 296 (22%) patients were readmitted within 30-days after index hospitalization. The proportion of 30-day readmissions was greater among patients discharged to a SNF compared to patients discharged home (27% vs 21%, p=0.031). After adjustment for age and sex, patients discharged to a SNF had a 40% increase in the odds of having a hospital readmission within 30 days post HF compared to those discharged home (OR: 1.42, 95% CI 1.01-1.99). Further adjustment for year of HF diagnosis, ejection fraction, anemia, renal function, dementia and cancer did not alter the strength of the association (OR: 1.43, 95% CI: 0.99-2.09). Conclusion: Among community patients with HF, 30-day readmissions remain frequent and are more likely to occur among patients discharged to a SNF compared to those discharged home. These data provide new insight into the drivers of HF readmissions and suggest that interventions targeted to HF patients in SNFs may be warranted.

scholarly journals Trends in the Use of Skilled Nursing Facility and Home Health Care Under the Hospital Readmissions Reduction Program

Medical Care ◽  
2019 ◽  
Vol 57 (10) ◽  
pp. 757-765
Author(s):  
Ioana Popescu ◽  
Neeraj Sood ◽  
Sushant Joshi ◽  
Peter Huckfeldt ◽  
José Escarce ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Hospital Readmissions ◽  
Skilled Nursing Facility ◽  
Home Health ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Reduction Program
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