Reduction in rehospitalization is an outcome measure used to evaluate home care services, especially in Outcome Based Quality Management using OASIS data; however, practitioners and managers must carefully analyze the reasons patients return to the hospital. This study examines events leading to rehospitalization of patients with CHF, whether it is possible to determine upon admission which patients are at risk, and whether the readmissions were necessary and/or preventable. Among the study's important findings are that half of the patients developed a new problem that required the rehospitalization. This and other research outcomes should be considered when analyzing adverse event reports.
Home care agencies are under pressure to deliver high-quality care with outcomes that demonstrate reduced patient rehospitalization. One approach found to be successful in reducing rehospitalization of heart failure patients is front loading visits. Our recent study showed front loading was effective for patients with heart failure, dramatically decreasing rehospitalization by more than one half (30.4% to 16%). Other methods utilized to enhance front loading are supplementation of visits with telehealth and/or telemonitoring and the use of established care paths. This article discusses the many challenges home care agencies face in implementing redesign and these best practice measures.
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