The Care Transitions Team, as part of the national CMS Integrating Care of Populations and Communities Aim, recently completed a project targeting the reduction of hospital 30-day readmissions.
Working with three different NY State communities, the
Team was able to promote cross-setting partnerships between participating hospitals, their referral affiliates, and other community service organizations to improve communications through monthly meetings designed to help each facility understand the unique challenges each one faces in taking care of patients. Additionally, interventions and analysis of readmission drivers were also incorporated. The result of these efforts was an almost 21% reduction of costly readmissions within 30 days.
View the press release for additional details on this project, the results of which were presented at the 19th Annual Institute of Healthcare Improvement (IHI) Scientific Symposium on Improving the Quality and Value of Healthcare.