A new edition of Health Affairs was published yesterday, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
For the next week, we will highlight pieces from this edition on our blog. Please share your comments with us as related to the Quality Chasm.
First up: "The Importance of Transitional Care in Achieving Health Reform," authored by INQRI program director Mary Naylor and her colleagues Linda Aiken, Ellen Kurtzman, Danielle Olds and Karen Hirschman.
Currently, one in five elderly patients discharged from a hospital is readmitted within a month. Seeking to address the human and substantial financial burden of revolving door hospital readmissions, the Affordable Care Act proposes a number of initiatives to improve care and health outcomes and reduce costs for the growing population of chronically ill people in the U.S. While transitional care is a central theme in these provisions, there is little information available to guide those responsible for implementing these important opportunities.
To bridge the gap, Naylor and her team reviewed existing programs in order to determine what works, for whom and for how long. They discovered “a robust body of evidence” that transitional care can improve health outcomes and reduce hospital readmissions. This paper highlights a range of solutions to reduce avoidable hospitalizations and health care costs.
Click here to read more.
Showing posts with label TCM. Show all posts
Showing posts with label TCM. Show all posts
Friday, April 8, 2011
Friday, May 28, 2010
Reducing Readmissions
This week INQRI's director, Mary Naylor, joined more than 200 hospital administrators, doctors, nurses and national experts for a discussion centered around developing strategies to reduce hospital readmissions in the five-county Philadelphia area.
Naylor described her transitional care model (TCM) which uses advance practice nurses to target the chronically ill elderly. This population accounts for 75 percent of Medicare costs. Using their intervention, Naylor's team reduced rehospitalizations through three months with a savings of more than $2,000/month/participant.
Click here to learn more about the event in the Philadelphia Inquirer.
Click here to read about the findings of INQRI researchers at Marquette University. This team has been working to prevent unnecessary readmissions by studying what hospital-based nurses do to influence outcomes that occur after discharge from a hospital.
Naylor described her transitional care model (TCM) which uses advance practice nurses to target the chronically ill elderly. This population accounts for 75 percent of Medicare costs. Using their intervention, Naylor's team reduced rehospitalizations through three months with a savings of more than $2,000/month/participant.
Click here to learn more about the event in the Philadelphia Inquirer.
Click here to read about the findings of INQRI researchers at Marquette University. This team has been working to prevent unnecessary readmissions by studying what hospital-based nurses do to influence outcomes that occur after discharge from a hospital.
Wednesday, August 19, 2009
AHRQ Innovations Exchange - Long Term Care
Check out today's edition of the AHRQ Innovations Exchange, highlighting issues in long term care.
A few highlights:
A few highlights:
- Interdisciplinary Team Identifies and Addresses Risk Factors For Falls Among Nursing Home Residents, Leading to Fewer Falls and Less Use of Restraints
- Nurse-Led Program Increases Provision of Cessation Counseling to Inpatients Who Smoke
- Nursing Home Learning Collaborative Improves Quality of Care, Reduces Staff Turnover
INQRI's Connection to Long Term Care
Although much of our work is focused on acute care settings, in the last couple of years, INQRI has expanded to other health care settings. To that end, we are very interested in the issues surrounding long term care.
"The Res-Care-AL Intervention Study" is a randomized controlled trial to test a restorative care intervention for assisted living (AL). The project incorporates patient centered outcomes (falls); nursing centered outcomes (restorative care services); and system-centered outcomes (staff turnover) as designated by the National Quality Forum. The primary aim of this study is to maintain or improve the residents' physical activity, physical status, function, and length of stay in the facility. The secondary aim related to residents focuses on mood, life satisfaction, resilience, self-efficacy and outcome expectations, social-support for exercise, and person-environment fit. This team is co-led by Barbara Resnick, PhD, CRNP, a nurse researcher, and Sheryl Zimmerman, PhD, MSW, a social worker.
Click here to check out an update on the project.
As previously mentioned in this blog, our program director, Mary Naylor is the Marian S. Ware Professor in Gerontology at the University of Pennsylvania. She is passionate about ensuring that top quality care is delivered across settings. Click here to learn about Dr. Naylor's transitional care model.
Tuesday, July 28, 2009
Transitional Care Cuts Hospital Re-Entry Rates, Costs
The NPR story featuring Mary Naylor's Transitional Care Model is now available online at NPR.org:
Here's a number that tells you a lot about what's wrong with the American health care system: When older patients get discharged from a hospital, 1 out of 5 of them will come right back within a month. Medicare pays $17 billion a year on these hospital readmissions. And in many cases, coming back should have been avoidable.
Mary Naylor is trying to change that. She started the Transitional Care Model at the University of Pennsylvania Health Care System in Philadelphia. A nurse with advanced training in geriatrics is assigned to an elderly patient while he is in the hospital and then follows the patient, with frequent visits and contact, over two or three months to help him manage his own care.
"Every time an older adult is hospitalized, it generally results in changes in their plan of care," says Naylor. Some of the instructions from a doctor can be hard to follow, like new prescriptions. "So they would go home and 24 hours after discharge have a set of prescriptions, drugs already in their cabinet and wonder, 'Should I be taking these plus these?'"
Here's a number that tells you a lot about what's wrong with the American health care system: When older patients get discharged from a hospital, 1 out of 5 of them will come right back within a month. Medicare pays $17 billion a year on these hospital readmissions. And in many cases, coming back should have been avoidable.
Mary Naylor is trying to change that. She started the Transitional Care Model at the University of Pennsylvania Health Care System in Philadelphia. A nurse with advanced training in geriatrics is assigned to an elderly patient while he is in the hospital and then follows the patient, with frequent visits and contact, over two or three months to help him manage his own care.
"Every time an older adult is hospitalized, it generally results in changes in their plan of care," says Naylor. Some of the instructions from a doctor can be hard to follow, like new prescriptions. "So they would go home and 24 hours after discharge have a set of prescriptions, drugs already in their cabinet and wonder, 'Should I be taking these plus these?'"
For the rest of the story and to hear the clip from Morning Edition, click here.
***
The INQRI program is very invested in ensuring good patient care quality at each stage of the health care journey. An INQRI team at Marquette University has been working for the past two years on discharge preparation.
Hospital readmission and emergency department utilization within the first 30 days following hospital discharge represent adverse, potentially avoidable, and costly outcomes of hospitalization. For their project, "A Quality and Cost Analysis of Nurse Practice Predictors of Readiness for Hospital Discharge and Post-Discharge Outcomes," Marianne Weiss and Olga Yakusheva, worked on linking the unit-level nurse practice environment and nursing care processes with patient outcomes at discharge and post-hospitalization. Specifically, the study examined direct and indirect causal relationships between the nursing practice environment, the discharge teaching process and readiness for hospital discharge with hospital readmission and emergency department utilization.
Dr. Weiss has published extensively regarding discharge readiness. To read her article, "Patients' Perceptions of Hospital Discharge Informational Content," co-authored by Lynn Maloney, click here.
Hospital readmission and emergency department utilization within the first 30 days following hospital discharge represent adverse, potentially avoidable, and costly outcomes of hospitalization. For their project, "A Quality and Cost Analysis of Nurse Practice Predictors of Readiness for Hospital Discharge and Post-Discharge Outcomes," Marianne Weiss and Olga Yakusheva, worked on linking the unit-level nurse practice environment and nursing care processes with patient outcomes at discharge and post-hospitalization. Specifically, the study examined direct and indirect causal relationships between the nursing practice environment, the discharge teaching process and readiness for hospital discharge with hospital readmission and emergency department utilization.
Dr. Weiss has published extensively regarding discharge readiness. To read her article, "Patients' Perceptions of Hospital Discharge Informational Content," co-authored by Lynn Maloney, click here.
INQRI Program Director Mary Naylor on NPR
INQRI Program Director Mary Naylor’s Transitional Care Model is scheduled to be featured today on NPR’s Morning Edition.
Click here to find your local NPR affiliate. The piece will be available online, via live and archived streams from NPR, to your desktop.
The Transitional Care Model (TCM) provides comprehensive in-hospital planning and home follow-up for chronically ill high-risk older adults hospitalized for common medical and surgical conditions.
For the millions of Americans who suffer from multiple chronic conditions and complex therapeutic regimens, TCM emphasizes coordination and continuity of care, prevention and avoidance of complications, and close clinical treatment and management - all accomplished with the active engagement of patients and their family and informal caregivers and in collaboration with the patient's physicians.
For more information on the Transitional Care Model, please click here.
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