What Works in Readmissions Reduction: How Hospitals Improve Performance

Area of Science:

• Healthcare Management
• Quality Improvement
• Patient Outcomes

Background:

• Hospitals aim to reduce avoidable readmissions, but evidence for effective strategies is mixed.
• Organizational practices, crucial for performance, remain understudied in readmission reduction.

Purpose of the Study:

• To investigate how high-performing hospitals reduced readmission rates.
• To compare clinical and organizational practices between high- and low-performing hospitals.

Main Methods:

• Qualitative study of 10 hospitals (7 decreasing, 3 increasing readmissions).
• Involved 82 hospital staff from the State Action on Avoidable Readmissions initiative.

Main Results:

• High performers fostered interdepartmental collaboration and shared expertise with postacute providers.
• High performers engaged in adaptive, trial-and-error learning and focused on patient outcomes over penalties.
• Both high- and low-performing hospitals implemented common clinical practice changes.

Conclusions:

• Organizational practices are critical for enhancing hospital readmission reduction efforts.
• Focusing on collaboration, knowledge sharing, and adaptive learning can improve performance.