Tackling Hospital Readmission

Hospitals have a problem. Frequently, when a patient is discharged, they are readmitted again within a month. Hospital readmission is a huge drain on resources. In North America hospitals spend billions of dollars a year on patients’ return visits.

For example, one in 20 Canadians who has a heart attack — a common cause of rehospitalisation — is urgently readmitted within a month of being discharged, according to the Canadian Institute for Health Information. An analysis published last year in the New England Journal of Medicine showed the chances of rehospitalisation only increase over time.

Tackling Hospital Readmission

Now, obviously, the goal isn’t to prevent individuals from returning to hospital if the need arises. The goal is to provide high-risk patients with the necessary information and tools upon discharge to limit their chances of return.

Hospital Readmission

As times change, hospitals have undergone many transformations to the way care is delivered. From the development of outpatient facilities such as the Jim Pattison Outpatient Care and Surgery Centre here in British Columbia, to the state of the art St. Josef Hospital and Pediatric Clinic in Neunkirchen, Germany, Hospitals are entering an era of change.

So how are hospitals tackling the problem of readmission? The answer is to give patients better follow-up care.

One solution getting growing attention is Project Red — for Re-Engineered Discharge — developed by Boston University. It includes the use of a “virtual discharge advocate” named Louise, who appears as an animated character on an interactive screen rolled up to a patient’s bedside to help in the discharge process.

Facilities in Florida and New Jersey have found another successful tool: nurse intervention and communication. For instance, focusing on nursing education, and have nurses explain discharge plans before patients are discharged.

Medication-related side effects and misunderstandings about what and when to take medicine is a leading cause of readmissions. Nurses, therefore can explain in detail to patients about the medicine they have been prescribed to avoid future complications.

One hospital in Florida devotes a nurse practitioner (NP) to provide transitional care for heart failure patients. The heart failure NP not only provides one-on-one training to the patient in the hospital but also ensures that patients are seen within 7 days of leaving the hospital and receive a follow-up phone call within 48 hours and 10 days of discharge.

For a full overview of hospital readmission challenges and solutions , have a look at this video created by the United States National Health Policy Institute.

[youtube=http://www.youtube.com/watch?v=dRUvsv5V1Pg]

 

Follow-up care is extremely important in reducing hospital readmission rates. All too often, patients are sent out the door without enough information in hand. However, with intervention, an onsite nurse or visiting coach can help cut the rate of readmission’s. 

Surrey Memorial Hospital Redevelopment

Last week we talked about advances in hospital architecture and design in our blog post The Five Star Hospital. The five star hospital is a great concept built around delivering the best possible patient care through non utilitarian means. 

Surrey Memorial Hospital Redevelopment

Why not create a hospital that not only functions well, but also gives patients and healthcare staff a place to feel comfortable? The new Surrey Memorial Hospital Redevelopment and Critical Care Tower aim to do just that. Creating a warm and welcoming facility is one of the key components of the expansion. 

Work is underway on a $512 million expansion and redevelopment project at Surrey Memorial Hospital. The centerpiece of this is an eight-storey Critical Care Tower that significantly continues to grow Surrey’s campus of Care.

The Surrey Memorial Hospital (SMH) was built in 1959 and served a population of 50,000 at the time. Over the years, SMH has undergone many transformations to meet the ever increasing demand. Currently Surrey has a population of 440,000 and continues to grow at a rapid pace.

With the help of our team at Iridia, the SMH expansion will address capacity and efficiency, well into the future. We are engaged with this project by providing assistance in the area of clinical and non-clinical physician services. We have led and facilitated meetings and discussions in physician leadership to gather data for projecting the needs of the new Critical Care Tower.

Watch this video to learn about the new Critical Care Tower now under construction at Surrey Memorial Hospital.

[youtube=http://www.youtube.com/watch?feature=player_embedded&v=i21t9fyNsHw&noredirect=1]

Key areas of the Surrey Memorial Hospital upgrade:

  • Upgraded infrastructure
  • Increased capacity of existing units
  • Expanded family birthing unit
  • Expanded pharmacy
  • New lobby

Key areas of the Critical Care Tower expansion:

  • 48 private rooms in a neonatal centre of excellence, with adjacent paediatric pharmacy
  • 25 Intensive Care beds
  • 20 beds for seriously ill patients in the High Acuity Unit, plus six more beds on the same floor 
  • Two medical floors of 36 beds each
  • An expanded laboratory
  • A rooftop helipad
  • More than 440 new parking stalls
  • Additional space for SMH’s clinical academic campus 
The new Emergency Centre is scheduled to open in 2013, while the rest of the Tower will be complete a year later.
Click on the images to see a detailed overview of the SMH expansion and Critical Care Tower.

With the population of Surrey expected to grow by an estimated 9,000 people per year, the SMH expansion is vital to the region.  The expansion and re-development of SMH will mean a significant improvement to patient care in Surrey, and will complement the new Jim Pattison Outpatient Care and Surgery Centre.

JPOCSC – A New Kind of Care

How does the new state of the art Jim Pattison Outpatient Care and Surgery Centre (JPOCSC) differ from a traditional hospital? The key is in the title, the JPOCSC provides “outpatient care” only. Outpatient care describes any medical care that does not require an overnight stay in a hospital; for example visits to the doctor’s office, clinics and a day surgery centre are all considered outpatient care.

So why build the JPOCSC, isn’t it just a very large doctor’s office, why is this different?

The answer is that typical hospital stays are very expensive. Each room that is in use is very costly and takes up limited hospital resources. These rooms are often filled with individuals who need surgery, but many of these surgeries are procedures that do not require a hospital stay. In today’s age up to 65% of surgeries do not require an overnight hospital setting.

Outpatient care is a divide and conquer tactic that is meant to keep costs down, as well as free up rooms in traditional hospitals. 

JPOCSC The Jim Pattison Outpatient Care and Surgery Centre has a vision of creating better health in the community by providing an integrated and seamless network of outpatient care services for residents of the Fraser Valley.

The facility embodies a new care delivery model by offering a one-stop approach to patient care, integrating both traditionally acute and community services and various clinical services.  Day surgery, diagnostics, specialty services and community health clinics will all be under one roof for the first time.

The JPOCSC is at the forefront of clinical service models, use of technology and green-space design.  As a state-of-the-art facility and the first of its kind in the Fraser Valley, the experience of working in the facility is new to all physicians and staff. 

Fortunately for us at Iridia, we have had the pleasure of working closely with Fraser Health on this project. Our president and founder has recently been appointed the Medical Coordinator of the JPOCSC. To read about about this appointment please see our post from earlier in the month: Leading the Jim Pattison Outpatient Care and Surgery Centre