Abstract WP28: Closing The Revolving Door: Reducing Stroke Readmissions

Abstract

Stroke is a leading cause of long-term disability where its impact and consequences can be pervasive. Although stroke management has evolved over the years, post stroke complications can lead to readmissions. It is estimated that approximately 90% of readmissions are unplanned resulting in an annual cost of $17.4 billion.The Centers for Medicare and Medicaid Services (CMS) in the attempt to limit preventable readmissions has adjusted hospital reimbursement based on these rates to establish accountability. As a Comprehensive Stroke Center, we instituted benchmarks in the attempt to decrease our re-admission rates. We recognize that the transition from in patient to outpatient services can create a vulnerable period that increases the risk for readmissions. Smart aim: To decrease 30-day readmission rates in the Stroke population at Cedars Sinai Medical Center Implementation process: We provided an inpatient pharmacist to implement stroke prevention medication education with an addition follow up phone call to address questions and confirm compliance. Secondly ensuring personalized Stroke education to patient and the families allowing assessment of needs prior to discharge. Thirdly calling our patients 7 days from discharge identifying if follow up appointments were made, prescription being taken and status in recovery. Results: From July 2020 to June 2021 the readmission rate was 9.5 %. Starting July 2021 to March 2022 we implemented the above modalities. This resulted in a decreased rate of 6.8% for this period. Conclusion: All the measures implemented made a significant improvement in the 30-day unplanned readmission rate for stroke patients. We recognized that inpatient and outpatient medication reconciliation provided one of the most significant factors that improved these rates. Proper medication education for patients and families improved adherence and in turn aids in secondary stroke prevention. Since this measure shows significant improvement, tracking and reviewing 90-day readmissions going forward seems prudent. Recognizing risk during this period allows the healthcare worker to intervene in anticipation of patients’ needs allowing for better patient outcomes and satisfaction as well as lessen the economic toll of care.