Judi Kulus, VP of Curriculum Development, AADNS

How can I help staff understand the importance of a sound discharge process that lowers readmissions?

Many nursing leaders are reeling from the 2% payment penalty implemented under the Value-Based Purchasing program effective Oct. 1. It’s too late to change your current VBP payment rate, but improving your facility’s discharge process can benefit future payment years by improving readmission rates.

The Agency for Healthcare Research and Quality designed its recently released Re-Engineered Discharge (RED) Toolkit to improve the discharge process by teaching residents self-care at home. Facility leaders can learn from AHRQ’s research, which found that the RED process improved resident satisfaction and outcomes and reduced hospital costs.

The RED toolkit spells out 11 steps to improving facility processes. A critical first step is selecting a senior management team member as sponsor and assembling a team of staff members to champion the rehospitalization-reduction process with strong commitments and clear goals.

Performance scores shown on Nursing Home Compare are outdated. The RED toolkit details a process for analyzing your current readmission rates and setting an improvement goal. This analysis should be parsed out by facility, by specialty, by unit and by diagnosis.

Next, consider developing a process map to enable easy visualization of each person’s role and of the gaps, incomplete tasks, and potential problems.

Another notable step in the RED process is post-discharge phone calls. The toolkit includes scripts that can help assess residents’ knowledge of their discharge instructions, assess medication compliance, and identify potential complications.