Abstract NS10: Reducing Readmission Rates Bedside Nursing Led Discharge Rounds

Abstract

BACKGROUND: A national benchmark does not exist identifying a rate for readmission of patients with ICD-9 codes for Stroke. The facility set its own benchmark goal of 13%. Analysis of the data for fiscal year 2013 found that 5 of 12 months of the fiscal year exceeded the benchmark goal ranging from 14.9% to 18.6%. Going into fiscal year 2014 It was realized that CMS would not reimbursement for readmissions within the first 30 days after discharge it was apparent that a process to reduce the readmission rate for stroke patients would be essential. PURPOSE: Implementation of a discharge rounding will reduce readmission rates to the benchmark goal of 13% for patients admitted with a stroke. METHOD: A discharge review process was started in September 2013 prior to the start of fiscal year 2014. The discharge review process was conducted by a phone conference including all patient care units. The participants from each unit included the director and charge nurse reviewing the readiness for discharge of patients on the unit. The information included in the process was a list of patients anticipated to be discharged and any potential barriers. This process would be evaluated at the end of each fiscal quarter with revisions made if goal was not met. CONCLUSION/RESULTS The initial discharge process conference calling resulted in a reduction of readmission rate to an average of 8.9% for the stroke patient. It was noted that the process was generic and needed to be tailored for specific patient populations if it was to be sustainable. The process was revised and decentralized to the unit level with the addition of case manager. In April 2014 the data was reviewed and found a readmission percentage rate of 7.4% for the quarter. The success of the project was reducing the rate well below the benchmark that had been set. To continue the trend rounds were brought to the nursing care area to include the bedside nurse. A discharge rounding tool was to be complete prior to discharge rounds. Data for the month of May 2014 shows a reduction in the rate to 5.3%. The discharge rounding has reduced the readmission rate for the Stroke patient and has exceeded the benchmark goal for two fiscal quarters suggesting the process is sustainable.