Post on 21-Jan-2017
Proven Strategies for
Reducing Readmission Rates
Earl Parker, Chief Operating Officer, Commonwealth Senior Living
Sandi Flores RN, President, Sandi Flores Consulting Group
(consulting VP of Resident Care to Commonwealth)
Commonwealth Assisted Living (CAL) Hospital Readmission Summary
Commonwealth Total (All Communities)
Beginning
(4th Qtr. 2014)
Current
12 Month Average
(2nd Qtr. 2015–1st Qtr.
2016)
Most Recent
Month –
April 2016
Hospital
Readmission
Percentage*
21.4% 12.1% 6.7%
Readmission
Rate per 1000
Resident Days
.44 .18 .10
*CAL percentages calculated by using: Number of Resident 30-day Hospital Readmissions/Number of
Resident Inpatient Hospitalizations
Reducing Rehospitalization Rates
As with most things, we believe that success is a
combination of PEOPLE and PROCESSES.
I am going to share with you a few things that we feel
have helped us to assure our PEOPLE are the right people,
in the right roles, and that they have the right focus.
Sandi is going to then share with you some of the
PROCESSES that have helped our PEOPLE to be successful.
CORE Values are built into all that we do C. OVERALL RATING:
6Models the core values extremely well
Low Job Skills
8Models the core values extremely well
Average to Solid Job Skills
HIGH
(7-9)
3Does not always model the core values
(average)
Low Job Skills
5Does not always model the core values
(average)
Average to Solid Job Skills
MED
(4-6)
1Poor example of core values
Low Job Skills
2Poor example of core values
Average to Solid Job Skills
LOW
(1-3)
LOW (1-3) MEDIUM (4-6) HIGH (7-9)
JOB SKILLS
V
A
L
U
E
S
9Models the core values extremely well
High Job Skills
7Does not always model the core values
(average)
High Job Skills
4Poor example of core values
High Job Skills
Combined with Noble Purpose
Our Noble Selling Purpose:
We improve the lives of seniors, their
families, and each other.
These are our key behaviors:
We listen.
We love.
We care.
We serve.
Hearing from our front line
We Care About People We Speak Up!
Prepare to Reduce Readmissions
1. Resident Care Systems (service planning/change in condition/incident review)
2. Staff competency
3. Tracking Data
4. RN availability for “case management”
Initiating Interventions
1. Medication reconciliation
2. Disease management basics (Multi-department)
3. Physician communication (Inter-facility Transfer Tool)
4. Mastering the process of prepping for the return from acute care (Care
Coordination Form and Process)
5. Medical professional assessment within 7 days of discharge
6. On going analysis (Not just data collection alone)