Healthcare News & Insights

8 steps to decrease readmissions for minority patients

Readmissions are always a concern for hospitals. And certain populations of patients are more likely to be readmitted than others – particularly black and Hispanic patients. The Centers for Medicare & Medicaid Services (CMS) just released a new report with a game plan for hospitals to help reduce readmission rates for racially and ethnically diverse patients. 

ThinkstockPhotos-465514535When breaking down readmissions by race and ethnicity, certain details stand out.

According to the CMS report outlining the new guidance, readmission rates for all the top conditions the agency monitors under its readmission reduction program are higher for black patients than white ones. And Hispanic patients have high rates of readmission for congestive heart failure and heart attacks.

Problems & solutions

While broad strategies targeting readmissions for patients from all backgrounds are important, specific patients face challenges that are better addressed by including a customized approach.

According to past research, challenges that may have a more significant effect on minority populations include:

  • discharge and care transitions
  • access to primary care providers/usual source of care
  • language barriers and access to interpreters
  • health literacy
  • culturally competent patient education
  • social determinants
  • mental health, and
  • co-morbidities.

Patient mix strategies

CMS offers several strategies hospitals can follow to address these problems in their patient mix.

Here are eight steps hospitals can take to minimize their negative effect on patients from ethnic and racial minority groups:

  1. Start discharge planning as early as possible. Since minority patients are less likely to follow up with the appropriate provider after discharge, it’s critical to begin planning for discharge immediately. Reminding patients of the importance of early follow-up care – and addressing any barriers that may keep them from following up (such as lack of transportation) – is much more effective if done right away.
  2. Connect patients with providers. Minority patients are less likely to visit primary care providers. With that in mind, ask patients if they have a primary care physician or other source of routine care. If not, have staff refer them to a provider and help them coordinate their first post-discharge visit.
  3. Use the patient’s preferred language for all care interactions. Make sure patients who don’t speak English well have consistent access to language translators during their stay and discharge. Discharge instructions should be administered in the patient’s native language, taking the person’s literacy level into account.
  4. Be aware of patients’ health literacy. Screen patients for their knowledge of health-related topics at the beginning of their hospital visit. Then tailor all interactions throughout each patient’s stay to his or her personal level of health literacy. Language should be simple and clear in discharge instructions, using terms the patient can easily understand while avoiding complicated medical jargon.
  5. Respect patients’ cultural beliefs. Certain customs and beliefs can shape how patients and their families react to information providers give them. Train doctors and nurses to be aware of some of the most common cultural beliefs of the ethnicities in their patient mix, and use that knowledge to better communicate with patients. If patients feel their beliefs are respected, they’re more likely to be receptive to providers’ instructions regarding aftercare and recovery.
  6. Assess patients’ social needs. Patients struggling with socioeconomic issues have a higher risk of being readmitted to the hospital. It’s important to gather information about any areas where patients need help and connect them with the appropriate resources. This could be anything from helping patients sign up for supplemental health insurance to connecting them with the local food bank or an employment agency.
  7. Screen patients for depression or other mental illnesses. Some minority groups are disproportionately affected by anxiety and depression. This can affect how well they care for themselves after discharge. So it’s crucial to screen all patients for depression and help them find appropriate mental health services. It’s also key for providers to support any coping methods patients use that may be influenced by their culture (such as spirituality).
  8. Focus on the full picture of each patient’s health. Comorbidities are common in patients, especially in racial and ethnic minorities. Providers must take all these conditions into account – not just the initial diagnosis that landed the patient in the hospital. Multidisciplinary disease management teams can be used to treat patients with comorbidities. If no one on staff can fully address one of a patient’s conditions, providers should make the appropriate referrals to specialists.

Ultimately, using these strategies together with a patient-centered approach is key to addressing the unique problems minority patients face that affect their health and recovery. This can improve outcomes and ultimately keep hospitals out of hot water with CMS for high readmission rates.

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