What can you really do about readmission rates?

Editor’s note: Janet Spiegel, MS, is a management consultant who has worked with several payer and provider organizations. She is currently a Lean senior strategic performance advisor at Martin’s Point Health Care in Portland, Maine.

When a healthcare leader charges a person or a team to solve some of the biggest national problems in care delivery—such as reducing hospital readmission rates—two things often occur: a surge of passion to make meaningful change, followed quickly by a sense of paralysis regarding where to start. But challenges, even massive ones like these, can be successfully addressed through a targeted problem-solving framework.

Define the problem

Reach out to your informatics/IT/data analytics team and let them know that you will need a partner for this effort. To start, ask for a report on your facility’s top 10 reasons for readmission. Using the Pareto Principle, you’ll likely see that 80% of the effects are caused by 20% of the causes. Let’s say your top two reasons for readmission are heart failure and COPD. Those are really big issues, so keep digging.
Go back to your data partners and ask for an analysis of readmissions due to heart failure and COPD in the last 12 months by patient age. What do you see first in the heart failure report? Are 80% of the readmitted patients over 60, for example? If so, ask your analyst what the patients were admitted for to begin with, or perhaps what counties those patients live in. Ask your analyst for his or her expert opinion on other data points worth analyzing. Keep asking questions about your results. This is called cause mapping: We want to keep asking what the causes are for the results so we can solve specific problems.

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