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patient readmission

Nicole Blaser, left, registered nurse/director of quality and compliance, Becky Rother, registered nurse/case manager and Dr. Kurt Kapels of Columbus Community Hospital pose for a photo Friday morning at the facility. The trio spoke with The Telegram about diminishing 30-day patient readmission numbers at CCH, which have dropped a little more than 42 percent from October 2016-May 2018.

Columbus Community Hospital was recently recognized by the Nebraska Hospital Association for its efforts regarding patient care improvement.

Specifically, CCH was honored for its work with the National Partnership for Patients’ Hospital Improvement Innovation (HIIN) Network initiative. The goal of the initiative, according to information released by the hospital, is to reduce preventable hospital-acquired conditions and readmissions and continually provide high-quality patient care.

Columbus Community Hospital from October 2016 through May 2018 made huge strides in terms of reducing all-cause 30-day readmissions which occur when patients are hospitalized for a short-stay and experience an unplanned readmission for any cause within 30 days of discharge. In that timeframe, readmissions were reduced by just more than 42 percent, which ultimately saved CCH $819,797.

“What it means for us is that we have been able to network with other hospitals around the United States and learn what their best practices are and what they are doing to improve care,” said Nicole Blaser, registered nurse/ director of quality and compliance. “And then we work to bring those tools, skills and resources to our organization and improve care for our patients.”

Perhaps even more vital to reducing local 30-day readmission numbers by nearly half has been the ability of Columbus Community Hospital health professionals to network quarterly – and oftentimes far more frequently – with other area health care providers, pharmacists assisted living and nursing home facilities.

“We collaborate in a very formal way with our skilled nursing facilities, our assisted living facilities, our home-health agencies and our retail pharmacies and our primary care providers,” she said. “We have regular meetings with them at the hospital where we sit down and say, ‘hey, this is confusing and not working well,’ or, ‘This really went great this time, let’s do that again next time.’

“It’s really helped us to develop relationships with those individuals so that when we have a challenging discharged patient where we know they are at high risk for readmission, we can all work together to say, ‘hey, Mr. Jones was here and these are some of the concerns that we have. When you see him in your clinic, make sure you follow up with these same concerns. When he picks up his medication at the pharmacy, can you please reinforce this? If he is going to your nursing home, can you please help us address this with him and his family.’”

Essentially, Blaser said, it’s taking the care outside the hospital’s walls to ensure that patients are still being monitored after their exit. Not having any major kinks in the health care chain reduces the chance a patient will return within that 30-day slot.

Taking patient care a step further, the hospital uses a risk calculator to assess how likely a given patient is to be readmitted following treatment, said Becky Rother, registered nurse/case manager at the facility.

“If they have had frequent ER visits, if they’ve had recent hospital stays, their age, comorbidities …” Rother explained of what the calculator assesses. “We based one specifically for our hospital based on the types of patients we generally see here at our hospital. And then those high-risk patients that we identify, we as case managers follow them for a 30-day period.”

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That consists of, she said, making frequent phone calls to the patients and their primary health care providers to see what the hospital can do to make the transition away from CCH as smooth as possible.

Nothing beats communication in terms of providing the best health care possible for patients utilizing CCH’s numerous services, said Dr. Kurt Kapels, clinical director of IPA hospitalists.

“We want to continually make that transition smoother from in-patient to out-patient so that the care providers that were caring for them here can get the information as needed to the folks (handling) outpatient to continue the treatment process,” Kapels said. “Because treatment doesn’t always end when you leave the hospital.”

Sam Pimper is the news editor of The Columbus Telegram. Reach him via email at sam.pimper@lee.net.

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