Reducing Psychiatric Inpatient Readmissions Using an Organizational Change Model

Area of Science:

• Health Services Research
• Quality Improvement Science
• Mental Health Services

Background:

• Thirty-day hospital readmission rates are a key quality metric for healthcare regulators and payers.
• There is a lack of published data on successful strategies for reducing readmissions across patient populations.

Purpose of the Study:

• To describe and evaluate the Wisconsin Mental Health Readmissions Project.
• To assess the project's effectiveness in reducing psychiatric inpatient 30-day readmission rates in Wisconsin.

Main Methods:

• A statewide quality improvement collaborative involving 19 county human services boards (representing 23 counties) from 2010 to 2013.
• Application of the NIATx organizational change model within a multicounty collaborative framework.
• Analysis of readmission rates using national and state databases (2009 baseline) and chi-square analysis to compare participating vs. non-participating counties.

Main Results:

• A statistically significant decline in 30-day readmission rates was observed in participating Wisconsin counties between 2009 and 2013 (P < .001).
• Participating counties experienced a 2.5% decline in readmission rates, compared to a 0.7% decline in non-participating counties.

Conclusions:

• The Wisconsin Mental Health Readmissions Project demonstrated a successful method for reducing inpatient behavioral health readmissions.
• Findings offer insights into effective quality improvement program design and interventions for reducing readmissions.
• Further research is needed to address the complexities of reducing behavioral health readmissions within healthcare systems.