Reducing Readmissions Through Follow-Up Appointment
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Presenter: Josee M. Gill, DNP, RN, CPHQ, LSSGB -Director, Quality – Henderson Hospital
Josee Gill serves as director of quality at Henderson Hospital in Henderson, Nev. She has been a member of NAHQ since 2017 and has presented a poster presentation at the IHRI Forum 2021 conference. She is certified in Lean Six Sigma Green belt and is focused on quality improvement measures to enhance quality metrics, drive strategic vision and advance patient satisfaction and outcomes.
Problem:
The hospital was seeing an increase in 30-day Medicare readmissions. Assuring a follow-up appointment prior to patient being discharged is a significant step towards reducing 30-day readmissions. Increased 30-day readmissions have led to increases the risk of a loss in revenue, patient dissatisfaction and can cause an increase in mortality
Tool:
Lean Six Sigma Green Belt Project which included a Rapid Process Improvement Charter, Cause and Effect matrix, Pareto chart, Five Why’s, and a Control Plan to sustain the changes.
Tool Selection:
Lean six sigma green belt projects use a systematic approach to problems and apply a DMAIC skills with complex processes using methods and tools that support a culture of data and facts based on decision making. Readmissions are complex and need a systematic approach to decrease readmissions.
Usage:
An interdisciplinary team developed a Cause and Effect matrix. Organizations often find that the same problem continues to occur even after a project. it is important to complete a Gemba walk to define the barriers along with data collection of contributing factors. Cause and effect matrix helped identified the problem.
Results:
Baseline data of a Follow-up appointment was at 25% prior to project. Barriers identified were – lack of education to Unit Coordinators to schedule appointment prior to discharge, patient with no primary care provider, no insurance, offices not answering phone, weekend discharge. After project 128% relative improvement from baseline.
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