title: Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.
abstract: Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (≥10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies.
authors.affiliation: 1 Ralph H. Johnson VA Medical Center , Charleston, South Carolina.|2 Division of General Internal Medicine, Department of Medicine, The Medical University of South Carolina , Charleston, South Carolina.
authors.forename: R Neal
authors.initials: RN
authors.lastname: Axon
authors.affiliation: 3 The South Carolina Hospital Association , Columbia, South Carolina.
authors.forename: Laura
authors.initials: L
authors.lastname: Cole
authors.affiliation: 3 The South Carolina Hospital Association , Columbia, South Carolina.
authors.forename: Aunyika
authors.initials: A
authors.lastname: Moonan
authors.affiliation: 3 The South Carolina Hospital Association , Columbia, South Carolina.
authors.forename: Richard
authors.initials: R
authors.lastname: Foster
authors.affiliation: 2 Division of General Internal Medicine, Department of Medicine, The Medical University of South Carolina , Charleston, South Carolina.
authors.forename: Patrick
authors.initials: P
authors.lastname: Cawley
authors.affiliation: 4 BlueCross/BlueShield of South Carolina , Columbia, South Carolina.
authors.forename: Laura
authors.initials: L
authors.lastname: Long
authors.affiliation: 5 Health Sciences South Carolina , Columbia, South Carolina.|6 The University of South Carolina School of Medicine , Columbia, South Carolina.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Turley
mesh_terms: D003266:Continuity of Patient Care / Q000592:standards*; D003299:Cooperative Behavior; D006801:Humans; D019982:Organizational Case Studies; D010359:Patient Readmission; D016730:Program Development; D058996:Quality Improvement; D013022:South Carolina