Preventing Avoidable Readmissions

Unit 2: Describe a Significant Clinical Issue 

Healthcare organizations and professionals define hospital readmission as a case in which a patient who has been discharged from a particular medical care institution is admitted again in a particular time interval. Hospital readmissions can be categorized into avoidable and unavoidable cases. Healthcare institutions across the globe have reported cases of readmissions as being a problem that potentially increases the cost of running the hospitals. According to Dinerstein (2018), one of the causes of hospital readmission is the early discharge of the patients before they are stable. The other cause of the readmission is that the patients may have been discharged to a location or facility that does not support recovery. The other cause of the upsurge in the cases of hospital readmission is the worsening of the original condition that the patient was suffering from due to poor follow-up or even bad luck (Dinerstein, 2018). The problem of hospital readmission is worsened by the fact that the hospitals are held accountable for the readmission rates even though the healthcare professionals and other members of staff can only control a few factors influencing readmission (Dinerstein, 2018). Additionally, healthcare analysts have reported that since medical care practitioners can only control a few factors that influence the hospital readmission rates, the situation is likely to improve slowly. According to Wilson et al. (2018), the factors leading to the readmission of patients within seven days is still unclear and presents a research problem that prompts further studies to probe into the readmission issue. As such, the hospital readmission rates can be effectively determined more so with the use of Electronic Health Records (EHR) (Wilson et al., 2018). The readmission rates are more likely to be found among older adults with more complex healthcare needs (Wilson et al., 2018). The paper, therefore, identifies a sustainable strategy that leads to the preventing of avoidable readmissions among the various patients in healthcare institutions. 

Unit 3: Research Problems and Designs 

The topic of research employs a qualitative research design. Qualitative research digs deeper than the quantitative study design into the issue of hospital readmissions by recording the responses and attitudes of the participants in a study. Moreover, qualitative research creates openness by encouraging the respondents of the research to discuss further on the new topics that have not initially been considered. The qualitative researchers are hence in a better position to delve more into the study regarding how the prevention of the avoidable readmissions can be done. 

The qualitative research also appears to offer the best level of evidence regarding avoidable readmissions to explore the management of care transition to reduce errors that lead to readmission compared to the quantitative research. Researchers are also in a better position to explore the other alternative given to the primary intervention. The alternative holds that IT could be employed to reduce the causes of readmission, such as by encouraging caregivers to research better ways of reducing the readmission rates. The primary outcome of reducing the avoidable readmissions is also delivered through the qualitative research design 

Unit 3: RUA: Topic Search Strategy 

Search Strategy 

The search terms that were used in the research include "avoidable readmissions", "prevention of readmissions", and the "prevention of avoidable readmissions". Aware of the broadness of the term readmission, the scholars narrowed down their search topic to cover only the avoidable readmission cases. Using the last stated search term that the researchers came up with, they looked it up both on google and google scholar as research databases. On google, the search phrase generated about 304000 search results in 0.44 seconds. On google scholar, the phrase generated about 13500 results in 0.12 seconds. The researchers then narrowed down the search to only include articles that have been published not earlier than 2016. About 5050 search results came up in 0.14 seconds. The refining of the research was performed to narrow down to the most relevant articles that explored the factors influencing avoidable readmissions in the healthcare institutions, as well as the interventions that can be given to reduce the issue among the patients, hospital staff, and the health systems worldwide. 

The most relevant articles on google scholar were chosen on the basis that they presented a primary research perspective on the issue of hospital readmission cases and how they can effectively be prevented over time. The most relevant articles had to include a solution with a technological perspective as one of the interventions being given for the prevention of avoidable readmissions. The selected two articles include “The Continuing Problem of Hospital Readmissions” by Chuck Dinerstein, and “Risk Factor Assessment of Hospice Patients Readmitted within 7 Days of Acute Care Hospital Discharge” by Wilson Anthony et al. 

PICOT Question 

The PICOT question that has been developed compares the interventions that have been stated to reduce the problem of readmission rates in healthcare institutions. 

The following is the PICOT question regarding the issue at hand. 

P	Problem	Increase in the avoidable readmission rates among the patients in the various institutions across the globe.
I	Intervention	Effective management of the care transitions in healthcare institutions worldwide to reduce the errors that encourage readmission.
C	Comparison intervention	Effective employment of Information Technology (IT), which includes clinical decision support
O	Outcome(s)	Prevention of avoidable readmission cases
T	Time taken	3 months

Therefore, the PICOT question is structured as follows. 

Among patients in the various institutions worldwide, how effective is the management of care transitions to reduce errors compared to the employment of the IT, including clinical decision support? 

Presentation of Problem 

The problem has been identified as the soaring rates of hospital readmission for the patients whose readmission cases are deemed avoidable. The primary intervention is to manage the transitions of care, which reduces the errors that are made as the patients are handed over from one healthcare professional to another. The comparison intervention is the effective employment of IT solutions to feature the clinical decision support and thus prompts the caregivers to make better decisions aimed at reducing the readmission rates. The Centers for Medicare and Medicaid Services (CMS), being part of the Patient Protection and Affordable Care Act (ACA) of 2010, penalizes the medical care systems with the readmission rates that are more significant than expected. The inception of the penalty and the employment of other programs have led to a significant reduction in the cases of hospital readmission rates. Nonetheless, the healthcare institutions have continued reporting the avoidable readmissions with the various factors influencing the rate of readmission being given (Dinerstein, 2018). The problem has continued being a menace for the hospitals across the globe, with an increasing number of patients being admitted again for the various illnesses that they originally had. 

Significance of the Problem 

The rise in the costs of providing healthcare to the various populations has significantly been observed, leading to an increase in the spending of healthcare institutions (Wilson et al., 2018). The patients have felt the pinch to a certain extent, especially in scenarios that they have been made to cater for their readmissions. The readmission rates have also exerted a copious amount of pressure on the health systems as they create space to accommodate the patients being admitted to the hospitals again. The hospital staff has had to work extra in a bid to take quality care of the readmitted patients besides those that are already at the hospitals. 

Evidence Available 

The issue of avoidable readmission of the patients to the hospital is worsening at the various medical care levels. Dinerstein (2018) provides evidence regarding the research question to the various scholars, which supports the primary topic of the research. To diversify more information from the author mentioned above, Wilson et al. (2018) elaborate more on the provided interventions meant to prevent avoidable readmissions. Firstly, the authors begin their research by focusing on the factors that influence readmission for the patients within seven days after having been in hospice care. Then, the researchers delve into the available evidence surrounding the solution to the problem. 

Purpose of the Paper 

The paper evaluates the various interventions aimed at preventing avoidable readmissions at healthcare institutions. Both interventions aimed at reducing the causes of avoidable readmissions have been documented to further expound on the purpose of the paper. The paper discusses how the care transition at the hospitals can be transformed to take care of the patients moving from one medical care practitioner to another (Wilson et al., 2018). Additionally, the authors magnify the necessity of IT while explaining that the disruptive form of technology boosts the healthcare outcomes, especially regarding the prevention of avoidable readmissions. 

Conclusion 

Hospital readmission rates are on the rise in the various medical care systems across the globe. Readmission has presented itself as an issue that actively affects the stakeholders of healthcare, which presents significant challenges to the caregivers and the health systems. Various interventions have been provided to solve the issue of readmission, with one of them being the effective management of the transitions in patient care at the healthcare organizations. That reduces the errors that lead to patient readmission. The second intervention is the involvement of IT, which increases the ability of the caregivers to make particular decisions that discourage readmission. 

References 

Dinerstein, C. (2018, October 3). The Continuing Problem of Hospital Readmissions. American Council on Science and Health . Retrieved from https://www.acsh.org/news/2018/10/03/continuing-problem-hospital-readmissions-13467 

Wilson, A., Martins-Welch, D., Williams, M., Tortez, L., Kozikowski, A., Earle, B., ... & 

Pekmezaris, R. (2018). Risk Factor Assessment of Hospice Patients Readmitted within 7 Days of Acute Care Hospital Discharge. Geriatrics , 3 (1), 4.