Reducing Hospital Readmission Rates: The HRRP Approach

Chapter 1 Introduction Readmissions are defined by Centers for Medicaid and Medicare Services CMS as hospitals all of over United States have been struggling with the thirty-day readmission rate. Medicare spent $17.4 billion in 2004 for patients' that are very sick and debilitated when they get readmitted in the hospitals (CMS.gov, 2016). The CMS has been looking into readmission rate in 2007 thru 2009 (Dharmarajan et al 2013). The Hospital Readmission Reduction Program (HRRP) provides resources to hospitals that have high readmission rate to help reduce and prevent readmissions. The diagnoses that are in a high risk of readmission are, heart failure, heart attack and pneumonia. The goal for this HRRP is to assist hospitals to reduce the

These programs are: 1.)Care Transition Program (CTI) that supports self-management for older adults, family and caregivers. This program's director is Eric A. Coleman, MD (www.caretransition.org, 2016). 2.)Project Re-Engineered Discharged (RED) helps manage patient’s transition to home. This program developed by Boston University of Medical Center. RED is supported by Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH) – National Heart, Lung and Blood Institute (NHBLI) (www.bu.edu, 2016). 3.) Transitional Care Model (TCM) is designed by Dr. Mary Naylor and a multidisciplinary team of colleagues at University of Pennsylvania, the transitional care nurse deliver and coordinate care for older adults that are high risk in readmission (www.transitionacare.info, 2016). 4.) Project Better Outcomes or Older adults through Safe Transition (BOOST) are a mentored implementation that is led by the Society of Hospital Medicine (SHM). 5.) State Acton on Avoidable Rehopistalizations (STAAR) is another HRRP program in three states: Massachusetts, Michigan and Washington. The program is run by Institute for Healthcare Improvement (www.ihi.org, 2016). These HRRP programs are currently adapted in Southeast Michigan to reduce and