A new initiative from the California HealthCare Foundation will focus on reducing preventable patient readmissions in 20 hospitals across the state.
Project BOOST (Better Outcomes for Older adults through Safe Transitions) is designed to reduce 30-day readmission rates, enhance patient satisfaction and improve the flow of information between hospitals and outpatient physicians.
The Society of Hospital Medicine developed Project BOOST in 2008. SHM is the medical society representing hospitalist physicians.
“By their very nature, hospitalists introduce discontinuity to care,” said Kate O’Malley, programs officer at the CHCF and the foundation contact for Project BOOST. “Someone else has to pick up the pieces once a patient leaves the hospital.”
A 2009 study in the New England Journal of Medicine found that unplanned readmissions cost Medicare $17.4 billion annually. President Barack Obama’s administration has identified readmissions as a potential source of savings, including reducing payments to hospitals with high numbers of patients who are readmitted.
“One of the reasons that readmissions to the hospital is such a big problem is that hospitals get paid for patient admission,” said Win Whitcomb, medical director of healthcare quality at Baystate Medical Center in Springfield, Mass., and physician advisor on quality initiatives for the SHM. “Not only has there not been an incentive, but there’s a disincentive for preventing readmissions.”
Funding from the CHCF will enable 20 California hospitals to be trained by SHM experts. CHCF’s support will cover a share of technical assistance costs for each hospital accepted into the collaborative; individual hospitals will pay a fee of $14,500.
“We’re very interested in the intersection of patient experience and the cost and quality of care,” said O’Malley. “Patients who don’t experience a good discharge process don’t do as well.”
According to Whitcomb, all the talk about readmissions and their financial repercussions is indicative of an urgent need to examine how hospital care is paid for in the United States.
One of the first incentives to reduce readmissions will be a federal financial penalty for preventable readmissions.
During the first year of the program, hospitals will look to improve their discharge procedures using SHM’s Project BOOST toolkit and mentorships with leaders in the field. The second year will focus on training additional mentors in California as part of an effort to build a sustainable infrastructure to allow gains to quickly spread throughout the state.
Recruiting for the California sites has just begun.
“I hope that Project BOOST can, in fact, reduce readmissions to the hospital,” said Whitcomb. “We have anecdotal proof, but we are looking for definitive proof.”