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Bellevue’s tools for reducing readmissions

bellevue

The original Bellevue  Hospital psychiatric facility.
Herewith Modern Healthcare’s look at how Bellevue Hospital, in New York City, a safety-net hospital, has succeeded in reducing readmissions despite the big difficulties in doing so at such hospitals, which  have disproportionate numbers of patients who are homeless, uninsured or simply sicker because they can’t afford regular medical care. Bellevue is nationally well known for the large number of its psychiatric patients, too.

This is part of a debate,  tied to government reimbursements and quality metrics for hospitals, over whether these institutions should be held responsible if their patients cycle frequently in and out of the hospital.

Advocates for safety-net hospitals say  that CMS penalties meant to reduce readmissions unfairly punish them. The CMS has agreed to  consider their complaints.

In any event, Bellevue has had some success in reducing readmissions. Among its strategies.

It  has implemented such readmissions-prevention initiatives as  as Project RED (for Re-Engineered Discharge), developed at Boston University in 2009. This requires care managers to track patients for 90 days after discharge to ensure that they obtain prescriptions or see primary-care doctors.

Bellevue uses a tidy, color-coded intake spreadsheet in its emergency department that lets the department’s chief of service  track  arriving patients. Besides such obvious details  as the patient’s name, vital signs and medications, it alerts doctors and nurses if the patient has been admitted within the past 30 days.

Bellevue also has  robust cooperation between its inpatient and outpatient care departments to help reduce readmissions. Indeed, as part of this effort, it built an outpatient clinic physically attached to the hospital.

To read the Modern Healthcare article on this, including data on its readmissions reductions, please hit this link.

 


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