Did you reduce avoidable readmissions in time to avoid the CMS penalty?

CMS Hospital Readmission Reduction Program starts today.
By now your hospital has carefully reviewed its own data and is using that data to identify the clinical conditions that you need to address to reduce potentially avoidable readmissions.  You've implemented some changes in your practices and are evaluating the effectiveness of those changes. If you are seeing consistent reductions in readmissions - bravo. If not, TheEvidenceDoc would like to help you with some tips and resources to help you identify practices that might be successful in your setting, by focusing on evidence based best practices.

What are evidence based practices? We'll define them as interventions for which there is consistent, scientific evidence showing improvement in the quality of care delivered to patients and leading to better patient outcomes.  And we'll call them practices that are demonstrated to be safe and effective.

There are several ways and places to look for evidence of safe and effective practices. In this post, we will consider research validated evidence and will demonstrate a free, widely available resource for locating research validated evidence.  TheEvidenceDoc -along with others like the Institute of Medicine (IOM), Agency for Healthcare Research and Quality (AHRQ) and the Cochrane Collaboration - recommends you use evidence derived from systematic review of research.  This systematic search for and retrieval of all the relevant research produces the best results for unbiased answers to what works.  And so we'll start by searching for systematic reviews.

One of the best search engines for accessing the published research is PubMed. PubMed is a service of the US National Library of Medicine that searches the MEDLINE database.  And even better, it includes a pre-built, relatively consistent and reliable search strategy for finding systematic reviews.

Screen shot of PubMed - You can find Clinical Queries search function under PubMed Tools

Screen shot of PubMed - You can find Clinical Queries search function under PubMed Tools

There are several phrases you could enter in the search box after clicking on Clinical Queries. If you enter the CMS phrase, potentially avoidable hospitalizations, you'll retrieve nine results in the category labeled systematic reviews.

PubMed Clinical Queries search for potentially avoidable readmissions

PubMed Clinical Queries search for potentially avoidable readmissions

Or you could enter phrases specific to the condition of interest for reducing readmissions. So you might search -  heart failure readmissions.

Not everything retrieved will be a systematic review. Or relevant to your setting. Or even of good quality. 

We'll provide more in-service training on those topics in another post.

But for now - happy hunting...TheEvidenceDoc