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Health care providers work to stem hospital readmissions

By Mark Bashore, WKAR News


Lansing, MI – LANSING, MI (WKAR) - Area health care organizations gathered today in Lansing to address one of their industry's most significant problems: re-hospitalizations. Patients and providers alike are often unprepared for the transition from one health care setting to another. That lack of coordination can lead to sudden readmissions to hospitals that cost billions of dollars a year. But there's a local effort to improve care transitions in mid-Michigan.


(SFX: patient admission)

That's the sound of a patient being admitted to Lansing's Ingham Regional Medical Center. Some of those patients are readmitted back to the hospital within days or weeks of their original discharge.

Experts say there's lots of room for improvement. Health care professionals acknowledge that patients often leave the hospital unclear about follow-up care or medications. Data from the Centers for Medicaid and Medicare show over 16 percent of mid-Michigan beneficiaries are readmitted to the hospital within 30 days. That number jumps to 23 percent for people who have experienced heart failure. The numbers are even higher in other parts of the country.

Dr. Stephen Jencks is a leading national expert on care transitions. He says the transition from hospital care to the next stage is far from seamless.

"It's sort of like an astronaut going between space stations without a space suit," Jencks observes.

Jencks says its crucial for patients to clarify specific information when they're first discharged from the hospital.

"One, the patient knows what medication to take and can get the medication," Jencks says. Two, that they have a follow-up appointment and they know how to get to it, and three, what the signs of danger are, of deterioration are, and they know who to call."

But coordinating all of a single patient's caregivers can be an elusive goal.

"We've increased our quote, unquote efficiencies' so when they go to the hospital, they're taken care of by a doctor that's never seen them before, quite often," explains Dr. Dennis Perry. He oversees case management at Ingham Regional Medical Center in Lansing. "When they go to a nursing home, who has another doctor who hasn't seen them and then maybe make it back to their family doc or internist who hasn't seen them for weeks or months. We need to sort of go back to some of the things we did before."

Another participant in the conference still takes part in a quaint practice of the past. Dr. Dan Fink is with the Visiting Physicians Association, a group of 130 doctors who specialize in house calls. The association serves 26,000 patients.

"They have oxygen tanks you know, they're the housebound patients who can't access medical services without a taxing effort," Fink explains. "So, we can send in a home health care team, a medical team, we can do all their testing at home. So then they offer balance and stability, rather than disaster and deterioration."

Health providers wrapped up today's conference in Lansing with a call to action: a public pledge committing to the next phase of the Care Transitions Collaborative. Next month, the participants will spend time focusing on one of the most common causes of readmissions: heart failure. Group members say by 2011, they hope to have smoothed out a health care landscape that by their own admission is far too fragmented.

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