Preventable hospital readmissions are excessive and costly. A recent study of Medicare data estimates that one in five elderly patients return to the hospital within 30 days of discharge. These preventable hospital readmissions cost an estimated $17.4 billion a year. Nurses know that frequent readmissions also represent poor quality care and inadequate care coordination.
The Centers for Medicare & Medicaid Services (CMS) define readmissions as an admission to a hospital within 30 days of hospital discharge. Beginning October 1, 2012, CMS penalizes hospitals with high readmission rates for patients with heart failure, heart attack or pneumonia by reducing Medicare payments. Hospitals can no longer afford to overlook the problem of preventable readmissions.
A recent survey reports strategies that hospitals use to reduce preventable readmissions. These strategies include improving discharge education, inpatient coaching, managing care transitions and telephonic monitoring after discharge. Many of the strategies are within the nurse’s roles and responsibilities. Nurses are key players in improving the quality of care to reduce preventable readmissions.
My book Economics and Financial Management for Nurses and Nurse Leaders helps nurses understand the link between nursing practice and health care costs. Nurses can learn to make a business case to support their ideas for improving care. For example, nurses can work with the health care team to write a business plan for telephonic monitoring of at-risk patients following hospital discharge. My book shows nurses how to identify and compare the costs and savings of a discharge monitoring program. Nurses can learn how to get funding for this and other care improvement programs.
Nurses know that expert clinical care improves patient outcomes and satisfaction. Nurses must also develop financial skills that link clinical care to costs and reimbursement. The skills developed in Economics and Financial Management for Nurses and Nurse Leaders support the nurse’s essential role in reducing preventable hospital readmissions.