94H - An AMC’s Approach to Reduce Unplanned Readmissions for High-Risk Patients

Wednesday, March 22

2:00–3:00 p.m.

Hospitals are incentivized to assertively manage patients’ length of stay and to discharge patients promptly and efficiently. They are also penalized if patients are readmitted unexpectedly to any hospital within 30 days of discharge, even when unrelated to the original admission condition. Efforts to implement timely, safe discharges that minimize unplanned readmissions are further impacted by patient complexity and social determinants of health. As healthcare systems provide more clinical services in ambulatory and virtual settings, those patients who are hospitalized tend to have a greater severity of illness and more complicated post-acute care needs. Patients’ social determinants of health affect their access to needed resources for post-acute care, placing them at increased risk for readmission.

Learn how MUSC addressed unplanned readmissions with a multipronged, data-driven approach to identify patients at medium and high risk for readmission, to capture patient-specific social determinants of health, and to develop and implement a comprehensive solution involving multiple stakeholders within and outside the organization to address this complex challenge.

Learning Objectives

• Understand the components of MUSC’s multipronged approach to reduce unplanned hospital readmissions.
• Recognize challenges and hurdles encountered in readmissions work and learn ways to overcome those challenges.