Healthcare News & Insights

Cutting readmissions for one deadly condition

Doctor explaining to PatientBecause of high federal scrutiny, hospitals are looking to reduce readmissions rates for a number of conditions. New research gives insight as to how facilities can cut the rates for an illness with a high percentage of readmissions: sepsis.

According to a news release, a study from the University of Michigan compared the readmission rates of patients diagnosed with sepsis to those who went to the hospital for various other acute illnesses. After three months, the readmission rates for both groups stood at about 42%.

But the patients with sepsis were more likely to be readmitted due to conditions that could’ve been prevented with the proper follow-up care.

Monitoring risks

Some of the most common conditions that caused sepsis survivors to go back to the hospital included:

  • kidney failure
  • lung failure
  • infections (particularly of the lungs, skin and soft tissue), and
  • a second bout of sepsis.

After surviving sepsis, patients have different risk factors that could make them sick again, compared to those who are hospitalized for other illnesses. For example, sepsis often attacks vital organs such as the kidneys, which leaves patients vulnerable to kidney problems. In addition, swallowing problems due to breathing tubes could lead to post-discharge complications in patients.

If these risk factors are specifically addressed during follow-up appointments with primary care physicians and other specialists, sepsis patients could avoid many of these health issues.

However, they’re not always singled out for these patients. Reason: They’re not on the typical list of “ambulatory care sensitive” conditions, or conditions that are common in patients who’ve recently visited the hospital. Doctors are typically on the lookout for these conditions once patients are discharged.

Because the risk factors for sepsis patients don’t appear on this list, they aren’t monitored as closely as they should be, and patients end up back in the hospital.

When putting together sepsis patients’ discharge plans, hospital staff should keep in mind the specific risk factors that can make patients sick again. Making sure that sepsis survivors are prescribed the correct medications and are counseled on best practices for recovery, including eating properly and watching for signs of infections, is key to the best outcomes.

And it’s also important to work with sepsis patients’ primary care providers and other outside specialists to make sure they receive the correct post-discharge monitoring. Example: Kidney function may need to be tested more often than normal to catch any developing signs of kidney failure.

How EHRs can help

Researchers suggest the best way for hospitals to get information about necessary follow ups across to the correct providers is to take advantage of their electronic health records (EHR) systems.

In an EHR, patients’ medical data isn’t just stored away in a file cabinet. It’s easily accessible and searchable. And with the right features, the information can be used to improve the outcomes of patients with sepsis.

By working with their EHR vendors and IT, hospitals can program their systems to “flag” certain signs and symptoms in sepsis patients. This can trigger reminders to encourage them to schedule follow-ups with specific providers post-discharge. That way, they can have their needs met by a provider who can best address them, which may not always be their primary care doctor.

Customizing your EHR like this isn’t just helpful for sepsis patients. The same principles can be applied to patients who have other serious conditions with high readmission rates, including heart disease. Programming your hospital’s EHR to recognize certain red flags that may harm a patient’s recovery, or require specific follow-up interventions, will keep those areas from falling through the cracks.

In time, data from EHRs could actually be used to create different ambulatory care sensitive condition lists for various illnesses. That would improve the continuum of care by making it easier for patients to see the appropriate provider once they’re discharged. Over time, this would potentially decrease readmission rates for all patients.

Given that potential, it may be wise to talk with IT and your EHR vendor to see if your current system has similar capabilities.

Many EHR systems are already programmed to highlight certain problems, such as issues with medications and potential allergic reactions. Find out if your system can take this a step further, and clearly identify comorbidities and other risk factors that may require the use of unconventional follow-up treatment for patients.

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