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Published on February 28, 2020

SRMC celebrates readmissions drop

Lori Dove, Harmohan Singh, Suzanne Jackson

Since beginning an effort in 2017 to reduce readmissions at Southeastern Regional Medical Center, the hospital has seen its most recent readmission rate drop below the national benchmark, and by some measurements even cut in half. Reducing the hospital’s rate of patients readmitted within 30 days of their last acute or observational stay is a national priority of the Centers for Medicare and Medicaid Services (CMS).

“We’re very proud of the work done by our team to address this issue,” said Vice President of Post Acute Care Services Lori Dove. “Southeastern Health’s vision for patients is to receive the highest quality care available in the most appropriate settings, whether it be at home, primary care offices, or skilled facilities.”

The CMS calculates benchmark readmission rates for individual hospitals based on the total number of patients and the number of acute patients, and then creates a ratio that compares the expected number of readmission patients and the actual number of patients who are readmitted for acute or observational stays.

Dr. Harmohan Singh has been the physician leader of this project and instrumental in its success.

“When the hospital started this effort, the most recent 30-day readmission data was slightly over 15 percent,” Dr. Singh said. “That figure had dropped tremendously in the last two years. Now it’s closer to 10 percent. In terms of raw numbers, we might have seen 160 readmissions each month in 2017, and now we are seeing about 80. Our ratio that the CMS calculates was 1.12 at the beginning of 2017, and at the end of 2019, that ratio was 0.78.”

This is the second year that SRMC has maintained a readmission rate below the benchmark. In December 2018, the ratio was 0.94

SeHealth Director of Population Health Suzanne Jackson applauded Dr. Singh’s efforts on this issue, as well as the other people inside and outside Southeastern Health who have been working together to lower readmissions. News of SRMC’s readmission rate changes have led Jackson to speak at conferences at the state and national level about SRMC’s success in tackling this issue.

“This milestone is due to a physician-led quality initiative using system resources, including hospitalists, cardiopulmonary rehabilitation, specialty clinics, skilled nursing facilities, the transitional care team, the Care Coordination department, diabetes education, emergency services, and community-based resources such as home health agencies, hospice agencies, transportation and spiritual networks,” Jackson said. “But the main driver from 2017 to date has been the physician-led peer-to-peer collaboration on a daily basis.”

Dr. Singh begins by reviewing all the readmissions to the hospital each day.

“I would find the barriers that had pushed them back into the hospital,” Dr. Singh said. “Perhaps they couldn’t get their medicine, or go to a primary care visit, or there was a lack of support, and so on. I’d analyze each admission, and we’d put parameters in place, making changes as we went along. This started in March of 2017, and by June we started to see the rate go down.”

Jackson said identifying the team to find the barriers was one step, followed by not allowing barriers to be excuses for lack of care. For example, if a patient had trouble getting medicine, the team would make the effort to see if the patient could qualify for charity care on their medication, or trade it out for a cheaper prescription. Here Southeastern Health’s Chronic Care Managers played a large role, for instance by helping patients get medications delivered to their homes, and by working with external resources to identify alternatives to the higher priced medications. Jackson said diabetic nurses have also been important in this process.

“We started asking ‘why’ instead of assuming,” Jackson said. “We learned from those questions and took more care at discharge, finding ways to offset barriers at the point of initiation. There was a learning curve, and there’s still a lot of barriers, but our goal is to continue to include more community partnerships and collaborate with physician networks to grow our ability to overcome those barriers.”