Home Health & Hospice Week

Accountability is the key to success with this important outcome.

You can kiss better rehospitalization outcomes good-bye unless you make prevention efforts a major priority from the top down.

Problem: Nearly 20 percent of Medicare patients discharged from a hospital are readmitted within 30 days. Home care patients overall have a 27 percent rate of rehospitalization, which means 891,000 home care patients are hospitalized every year, said Eileen Freitag of Fazzi and Associates in Northampton Mass., during a webinar addressing the new Delta study to reduce avoidable hospitalizations. All those rehospitalizations for home care patients rack up $6.4 billion in costs annually.

Opportunity: If the home care industry can reduce unplanned hospitalizations, "we can have a significant impact on healthcare financing in this country," Freitag said. It's also an opportunity for agencies to have a positive impact on quality and quality scores, as well as a benefit to patients and families who will experience less disruption, she said.

Accurate OASIS assessments translated into effective care plans can help improve your agency's hospitalization statistics, but agency accountability is one essential technique many providers are overlooking.

Note These Surprising Findings

The Delta study to reduce hospitalizations revealed some unexpected findings, says Fazzi's Gina Mazza. Perhaps the most interesting result was that the agencies with the highest unplanned hospitalization rates and the agencies with the lowest unplanned hospitalization rates all used the same strategies to prevent hospitalization. (See box, p. 68, for the top five strategies for preventing unplanned hospitalizations.)

So if everyone is using the same prevention strategies, why do unplanned hospitalization rates vary from agency to agency? "The difference in success and failure is not the practice, but the implementation of the practices," said Bob Fazzi during the webinar.

Agencies with the most success in preventing unplanned hospitalizations have an accountable leader, Mazza tells Eli. This leader is responsible for promoting the project, making certain people have time to participate in project activities, and tracking and assessing whether goals are met.

Bottom line: The accountable leader establishes each individual's responsibilities and in turn holds them responsible, Mazza says. She must also make sure everyone has the tools they need to succeed and knows what is required.

Give Audit Processes A Check-up

The Delta study also found that more than 69 percent of home health agencies use audits as a strategy to prevent unplanned hospitalizations. But not all agencies have success with this method.

Why? Many agencies say they do a real-time audit of patients who are hospitalized, Mazza says. But it was those agencies that included a complete communication loop in their audit processes that have the best results.

A good post-hospitalization audit uncovers what happened to cause the patient's hospitalization and determines whether it was preventable, Mazza says. That information is then tracked and shared with employees to make certain everyone involved learns from it.

"Auditing significantly reduces unplanned hospitalizations," Mazza says. "Unfortunately, not everyone does everything by the model."

Next up: Fazzi is currently conducting an eight-month study of the SafeSide Hospitalization Reduc-tion Program. It's an accelerated, measurable hospitalization reduction model designed to help agencies achieve a decrease in avoidable hospitalizations and an improvement in Home Health Compare hospitalization rates.

You can initiate the SafeSide model in a short period of time, using existing agency resources, Fazzi explains on its website.

Note: The Fazzi webinar on the Delta study is at www.screencast.com/t/TecnF3Xx. For more on the SafeSide model, see www.fazzi.com/safeside-faqs.html.