Kindred’s long-term acute care hospitals (LTACHs) have reduced readmission rates from 15 percent in 2010 to 11 percent in the first half of 2012. “Healthcare’s attention was turned to reducing hospitalizations in 2009 when Jencks, Williams, and Coleman showed that almost 20 percent of Medicare patients discharged from the hospital were readmitted within 30 days,” says Sean R. Muldoon, M.D., M.P.H., Senior Vice President and Chief Medical Officer of Kindred Healthcare’s Hospital Division. “Kindred had been tracking re-hospitalization rates for at least 10 years, but after the Jencks study, we began to really look at how we could decrease re-hospitalization rates not only for our short-term hospital partners, but also in our own post-acute care sites of service.”

To reduce re-hospitalization rates, their first step was to convene a task force to examine re-hospitalization data in high- and low-performing LTACHs. “As a result of this work, which was led by Vice President of Clinical Operations Deb Graves, we pinpointed structures and processes of care that seemed related to re-hospitalizations,” says Muldoon. “We identified numerous factors that were changeable.”

Some of the changes that were made based on the task force’s findings include the following:

  • Upgrading procedure rooms
  • Expanding intensive care-level beds
  • Adding CT scanners
  • Formalizing house physician duties to include early intervention for patients who are experiencing a change in condition

The hospital division has launched a campaign called “Delivering the LTACH Message,” recognizing that reducing readmissions starts with the preadmission process. The campaign includes training of our hospital and sales staff around formal scripting for patients, families and referring colleagues about the services our LTACHs provide. “When a change of condition occurs, a combination of early recognition, early intervention, and knowing that Kindred is equipped to handle patients at a high level of care has helped to prevent the sometimes reflexive reaction to transfer patients back to acute care,” Muldoon says.