Hospital Readmissions
In any profession today, quality control means the prevention of problems that were the aim of the business to solve in the first places. Recurrence of these problems means that the business has not been functioning optimally and a new strategy or focus is required. In the health care setting, such a challenges is presented by hospital readmissions. When a person is discharged from hospital after receiving treatment for a certain condition, this means that the aim to persuade the patient with a remedy for the condition was reached. Readmission for the condition at some future date means that the remedy was not sufficient and a different strategy needs to be followed. There are several focus points when considering the readmission of patients to hospital and how this can be prevented. Upon final analysis, it is indeed possible to prevent this and the health care professional has an obligation to follow protocols that have been put in place to accomplish such prevention.
Minot (2008) points towards the possibility that, although many readmissions can and should be avoided, it should nevertheless not be the aim to avoid readmission at all costs. Some conditions, for example, require repeated treatments, and failing to readmit patients with chronic conditions is not only dangerous, it is also irresponsible. A person with cancer, for example, would receive intermittent treatments without which most such patients would die.
On the other hand, however, Minot also notes that many readmissions can and should indeed be prevented. This category of patient includes those with one-time conditions that should be treated once and prevented from occurring in the future. Such patients benefit not only from initial treatment, but also from counseling on how to retain their health in the long-term and thus prevent readmission for the same condition. The seriousness of the condition also plays a role. Persons with heart failure, for example, needs particularly close attention with regard to preventative measures. Even when sufficient counseling is provided, the condition often does result in rehospitalization. This is detrimental not only for the economy, but also for a patient's general sense of well-being and health, which also impacts more specific health concerns. In the interest of all parties, it is therefore desirable to, where possible, reduce readmissions.
In addition to focusing on readmissions as a costly problem for the United States and its health care system, Sims and Hadi (2011) also suggest that certain populations are most vulnerable, with specific focus on senior citizens. This is a significant concern, since the Western world is gradually ageing, with fewer births and a death rate at a much higher age than has ever been the case in human history. This has a significant effect on the health care system and the way in which readmissions should be conceptualized. According to the authors 20% of Medicare patients are being readmitted within 30 days after discharge. In 2012, the readmission policy in terms of the economy has become to penalize hospitals that show a higher admission rate by offering lower reimbursement rates for these hospitals. Hence, in the interest of both patient and health care provider, it is a reasonable aim for hospitals to, as far as possible, reduce unnecessary readmissions.
For senior citizens, Sims and Hadi (2011, p. 3) suggest modern electronic means such as video chat. This follows the authors' finding that follow-up communications with health care providers is one of the key factors that affect senior citizens and their readmission to hospitals. Hence, the concept of video chatting was used to design a device to specifically help senior citizens communicated with their health care providers without the cost and effort of a physical hospital or office visit. A simple touch-screen user interface formed the basis of the device, which was dubbed "Touch." In terms of appearance, the device could also be used as a picture frame when not being used. In this way, senior citizens are provided with a device that easily and immediately connects them with a professional or family member to answer questions or help with strategies to prevent unnecessary readmission to hospitals. From the health care perspective, this device is also highly beneficial to professionals themselves, since the time and cost investment involved in office visitations is reduced in this way.
Gonseth et al. (2004) also focus on older citizens, but those suffering from specific conditions such as heart failure. The authors investigate the effectiveness of enrolling these citizens in disease management programs in order to reduce the likelihood of readmission. Such programs have several positive impacts; it offers senior citizens the opportunity to communicate not only with health care providers,...
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