Forum seeks to cut return hospital visits
Grotta Fund sponsors all-day conference on improving patient care
Dr. Andrew Miller called rehospitalization “a significant problem. You don’t want to be in the hospital if you don’t need to be.”
Photos by Robert Wiener
October 9, 2013
It happens far too often — patients leave the hospital after treatment or serious surgeries, then, within 30 days or less, need to return for more care.
Rehospitalization can be scary for patients and their families, but can also add millions of dollars each year to the nation’s health-care costs.
With those concerns in mind, the Grotta Fund for Senior Care convened an all-day forum on reducing unnecessary rehospitalizations.
The Oct. 1 event at the Aidekman Family Jewish Community Campus in Whippany drew 150 representatives of health-care providers and community groups.
“The purpose of the day was to educate providers on how we can improve the care of seniors when they are discharged from the hospital and return to their homes and other settings,” said organizer Renie Carniol, director of the Grotta Fund for Senior Care of the Jewish Community Foundation of MetroWest, speaking a day after the program. “We want providers to educate and empower seniors so that they can take better care of themselves. This will prevent rapid rehospitalizations.”
Dr. Andrew Miller, the medical director of the federally funded Healthcare Quality Strategies in East Brunswick, described the scope of the problem. Under the Affordable Care Act — which took effect on the day of the conference — hospitals with high readmission rates incur penalties, he said.
“Fifty-eight out of 63 hospitals in New Jersey will be penalized this year,” he said. “That is the second-highest in the country after the District of Columbia…. From a financial point of view it is important for hospitals to pay attention to this.”
As for patients, “You don’t want to be in the hospital if you don’t need to be,” said Miller. “You are potentially exposed to infections and you are exposed to errors, even in the best hospitals.”
In her presentation, Dr. Jane Brock, the chief medical officer for community action at the Colorado Foundation for Medical Care, said that one out of every five patients gets brought back to the hospital within 30 days.
The remedy to this situation lies in “bringing communities together,” she said. “We found community organizing to be a very powerful way to bring major players to the table and keep them at the table.”
Later a panel of hospital executives described such partnerships.
CEO John Brennan of Newark Beth Israel Medical Center referred to Project RED, a standardized approach to “re-engineered discharge” planning developed at Boston University Medical Center.
At Newark Beth Israel, under a Grotta Fund grant, a protocol is being used to reduce the readmission rate of congestive heart failure patients.
“Making sure we track that patient, better educating of patients about their diseases and medications, and following up on appointments” all help to reduce readmissions, said Brennan. “If you can get a patient seen in the first seven days after discharge, their rate of readmission goes down significantly.”
A Grotta Fund grant also helped three organizations based in Elizabeth — Holy Redeemer Health Care, Trinitas Regional Medical Center, and the Jewish Family Service of Central New Jersey — join together in 2011 to seek solutions to seniors’ readmissions.
“We do a lot of work in the hospitals to engage the patients and learn about the patients, their cognitive health, and their physical health,” Central JFS associate director Carol Billet-Fessler told NJJN. “We continue with nursing care and social work services after the patient is discharged. One of the major problems with many of our patients is poverty, so the close monitoring of health and socioeconomic issues really makes a difference in preventing rehospitalization.
“We are grateful to the Grotta Fund for enabling us to help our community in this way.”
Susan Schechter, clinical coordinator of older adult services at Jewish Family Service of MetroWest, described a wellness program her agency runs in collaboration with Saint Barnabas Medical Center in Livingston and the four senior facilities run by the Jewish Community Housing Corporation, based in West Orange.
“We are committed to keeping older adults in the community for as long as possible,” Schechter said. “It is all about quality of life for older adults and their caregivers. The revolving door has such an awful effect on mental health issues.”
The forum was cosponsored by Freedom Home Healthcare, the Wallerstein Foundation for Geriatric Life, and the New Jersey Hospital Association.
“Our next cycle of funding addresses coalition-building, which is happening around the country,” Carniol said. “We need to bring all hands together and do better than we are doing now.”