University of Southern Indiana nursing and social work students partnered with the Heart Hospital at Deaconess Gateway to help reduce hospital readmissions in Southwestern Indiana. The three-year federally-funded initiative began in 2009. The Evansville area, which includes healthcare facilities as far north as Vincennes, was one of 14 communities across the country to receive grants for the project.
Dr. M. Jane Swartz, assistant professor of nursing, worked with students in the College of Nursing and Health Professions and the College of Liberal Arts to involve them with Deaconess patients both before and after their treatments. Research has identified these care transitions as areas where there is great opportunity for improvement.
Students learned to educate patients and facilitate understanding about their care using a strategy called “Teach Back”. This model teaches patients to properly use their medications, maintain visits with health care providers after discharge, know the symptoms of a worsening condition, and keep personal health records. “The hope is that these patients will be more engaged in their care and therefore reduce their readmissions,” Swartz said.
History and Implications
Research over the past decade has shown that a significant number of patients are readmitted to care facilities after discharge. A goal of the federal Patient Protection and Affordable Care Act is to increase the quality of patient care, especially for Medicare beneficiaries. For this reason, the Centers for Medicare & Medicaid Services (CMS) awarded research grants to state Medicare quality improvement organizations. Health Care Excel, Indiana’s quality improvement organization, chose the Evansville hospital service area for the project.
Local care transitions initiatives could ultimately affect the local healthcare industry. In October, CMS began incentivizing hospitals to maximize their effectiveness by reducing Medicare and Medicaid reimbursements to health care facilities with high readmission rates. “Reimbursement will play a part in nursing jobs,” Swartz said. “Students are learning that they will have to be accountable in their future nursing.”
The outcomes of the national initiative were featured in the January 23 issue of The Journal of the American Medical Association. Data from the Evansville area was included.