Key result
High-performing hospitals (n=7) reduced readmissions through organizational practices like cross-department collaboration and sharing expertise, distinguishing them from low-performing hospitals (n=3).
Why the study?
What organizational practices distinguish hospitals that successfully reduce readmission rates from those that do not?
What organizational practices distinguish hospitals that successfully reduce readmission rates from those that do not?
Organizational practices, such as cross-department collaboration and sharing expertise with postacute providers, may be critical to successfully reducing hospital readmissions.
Answers are grounded in this paper and cite their sources.
May guide readmission-reduction strategies; leaves open causal effects and generalizability beyond this qualitative sample.
BACKGROUND: Hospitals across the United States are pursuing strategies to reduce avoidable readmissions but the evidence on how best to accomplish this goal is mixed, with no specific clinical practice shown to reduce readmissions consistently. Changes to hospital organizational practices, a key component of context, also may be critical to improving performance on readmissions, but this has not been studied. OBJECTIVE: The aim of this study was to understand how high-performing hospitals improved risk-stratified readmission rates, and whether their changes to clinical practices and organizational practices differed from low-performing hospitals. DESIGN: This was a qualitative study of 10 hospitals in which readmission rates had decreased (n=7) or increased (n=3). PARTICIPANTS: A total of 82 hospital staff drawn from hospitals that had participated in the State Action on Avoidable Readmissions quality improvement initiative. RESULTS: High-performing hospitals were distinguished by several organizational practices that facilitated readmissions reduction, that is, collective habits of action or interpretation shared by organization members. First, high-performing hospitals reported focused efforts to improve collaboration across hospital departments. Second, they helped postacute providers improve care by sharing the hospital's clinical and quality improvement expertise and data. Third, high performers enthusiastically engaged in trial and error learning to reduce readmissions. Fourth, they emphasized that readmissions represented bad outcomes for patients, de-emphasizing the role of financial penalties. Both high-performing and low-performing hospitals had implemented most clinical practice changes commonly recommended to reduce readmissions. CONCLUSIONS: Our findings highlight several organizational practices that hospitals may be able to use to enhance the effectiveness of their readmissions reduction efforts.
No takes yet. Share an insight, caveat, or question.
Brewster et al. (2016) studied Hospital readmissions (n=82). Organizational practices (collaboration, sharing expertise, trial and error learning) vs. Low-performing hospitals was evaluated on Differences in clinical and organizational practices between high- and low-performing hospitals. High-performing hospitals (n=7) reduced readmissions through organizational practices like cross-department collaboration and sharing expertise, distinguishing them from low-performing hospitals (n=3).
Synapse has enriched 10 related papers. Consider them for comparative context: