title: HF readmissions drop after initiatives.
abstract: By analyzing heart failure readmissions and collaborating with post-acute providers and community organizations, Essentia Health-St. Joseph's Medical Center in Brainerd, MN, cut its readmission rate from 18% to a low of 6%. An interdisciplinary team analyzed readmissions, interviewed patients who were readmitted, and developed the program. Initiatives include setting primary care appointments while patients are in the hospital, following up after discharge, and creating order sets that include best practices. The hospital staff meet regularly with post-acute providers and social service agencies to brainstorm ways to create smoother transitions and ensure that patients get what they need after discharge.
mesh_terms: D003299:Cooperative Behavior; D006333:Heart Failure / Q000534:rehabilitation; D016519:Hospitals, Religious; D006801:Humans; D008910:Minnesota; D019982:Organizational Case Studies; D010359:Patient Readmission / Q000639:trends*; D011785:Quality Assurance, Health Care / Q000458:organization & administration