Reducing Readmissions Through Follow-Up Appointment-Video - Reducing Readmissions Through Follow-Up Appointment

Video Transcription

Video Summary

NACU hosted a Healthcare Quality Week webinar on reducing hospital readmissions through ensuring patients leave with a scheduled primary care follow-up appointment. Presenter Josie Gill, RN, DNP (Director of Quality, Henderson Hospital; CPHQ; Lean Six Sigma Greenbelt) explained why readmissions matter: they affect millions, increase mortality risk, cost the U.S. billions, and impact CMS star ratings and reimbursement.<br /><br />Using rapid process improvement (RPI) methods, her team chartered a project targeting five diagnoses (COPD, pneumonia, AMI, CHF, total hips/knees) with a baseline readmission rate around 16%. They mapped the workflow with SIPOC, then used a cause-and-effect matrix and 100 chart reviews to identify key contributors. A Pareto analysis showed the biggest opportunity was the lack of a follow-up appointment scheduled before discharge.<br /><br />Interventions included training unit coordinators on scheduling/documentation, creating a shared resource binder of accepting providers (including low-cost options), and partnering with clinics to improve appointment access (including weekend/phone delays and telemedicine). Follow-up appointments before discharge rose from 25% to ~60–65%, statistically significant, and readmissions dropped to ~10%. A control plan and ongoing unit-level transparency helped sustain gains. Q&A addressed barriers like patient noncompliance, transportation, and preferred appointment times, emphasizing early (within 7 days) follow-up and additional post-discharge supports.

Keywords

hospital readmissions reduction

primary care follow-up appointment

discharge planning process improvement

rapid process improvement (RPI)

SIPOC workflow mapping

Pareto analysis and chart review

CMS star ratings and reimbursement impact

telemedicine and clinic appointment access