MEMORANDUM TO THE HEALTH WAIKATO ADVISORY COMMITTEE AGENDA ITEM 4.2

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1 MEMORANDUM TO THE HEALTH WAIKATO ADVISORY COMMITTEE 10 JUNE 2015 AGENDA ITEM 4.2 Subject Unplanned Acute Readmission Presentation By Author Mark Spittal, Group Manager & Thames Purpose of the Presentation To update the Committee on how is performing in relation to readmissions rates. Key Points Ministry reporting on readmission rates has been suspended for all DHBs due to technical issues. Hospital benchmarks its rates against peer facilities. The Planned Discharge Project is the vehicle through which improvements are being targeted. Recommendation(s) That the report be received.

2 REDUCING UNPLANNED READMISSIONS Introduction Unplanned readmission rates are an important indication of service quality. The Ministry of Health routinely monitors DHB readmission rates as one of the Ownership Indicators. DHB performance has not met the Ministry s KPI for some time. However, reporting against this indictor has been suspended for all DHBs from this quarter due to technical issues in the way the KPI has been measured. It is anticipated that the methodology, which dates back to the early 1990s, will be significantly overhauled. Consequently there is uncertainty about how s true performance compares to other DHBs. Australian Comparisons Notwithstanding the issues with the Ministry s reporting at DHB level, within this DHB Hospital actively contributes to a benchmarking programme with a large number of hospitals in Australia and New Zealand. These Health Round Table comparisons indicate Hospital s readmission rate has improved after a deterioration in the first quarter of Hospital s unplanned 280-day readmission rate now sits below that of other tertiary hospitals. However, at just below the 75th percentile, further improvement is desirable. This is compounded by the fact s internal reporting uses a different methodology again, which tends to report a higher rate than the Ministry s KPI. Notwithstanding these technical issues, unplanned readmissions are an important issue and work is underway as part of the discharge project to achieve a reduction in those that are preventable. The data that we receive from the Health Roundtable is anonymised. The following tables show our trends, and comparisons with other like institutions. Page 1

3 There are several specific conditions for which the unplanned readmission rates indicate further enhancement to the system of care is desirable. For example, unplanned readmission rates following acute myocardial infarction are low relative to other New Zealand tertiary hospitals, but also show a highly seasonal pattern that peaks in winter when admissions also peak. This suggests the overall rate can be improved if risk factors that affect the rate in winter can be mitigated. Page 2

4 Page 3

5 Unplanned Readmissions Post-Acute MI (Trend) Unplanned readmission rates do not necessarily reflect overall service performance. For example, the unplanned readmission rate following hip replacements is low at (0.9%), but the unplanned readmission rate for knee replacements is high relative to peer hospitals, being just above the 75th percentile at 3.1%. The rate for knee replacements has been well below the 75th percentile since January 2013, but spiked in the final quarter of before returning to be below that percentile in the first quarter of Ongoing monitoring will confirm whether the hospital is back within the expected range. The HRT benchmarking has flagged readmission rates follow tonsillectomy and adenoidectomy as an area that requires focus. Unplanned Readmissions Post-Tonsillectomy & Adenoid Ectomy (Trend) Page 4

6 These rates spiked during the 2014 calendar year which has made rank poorly, relative to its peers (17th out of 19) Report Card Caution must be taken, however. This result relates to 5 patients out of 371 and the readmission rate has dropped significantly (although still high) in the last quarter. also had a high rate of readmissions within 28 days following post-natal discharge in the last half of 2014 but normally tracks close to the 50th percentile. Again, this aspect of performance is being monitored. Post-Natal Readmissions: HRT Comparison These benchmarks indicate that readmission rates are highly related to particular conditions and can fluctuate significantly. Trend analysis over time is therefore the best indicator of performance. Preventable Readmissions The international evidence is that the most effective tactics for reducing readmissions are designed to achieve two simple objectives: 1. Ensure patients (and whānau support) know how to care for themselves when they leave hospital. 2. Ensure patients receive the follow-up medical attention they need to keep their condition(s) under control. The tactics that best support these objectives are obvious. 1. Ensure timely and appropriate referral to post-acute care. 2. Improve discharge planning by empowering the patients to self-manage, improve medicine reconciliation, and facilitate timely physician follow-up. Page 5

7 These tactics reinforce the basic imperative for seamless cross-continuum care. Some effective interventions have included incentivising timely follow-up in the primary care setting, and a focus on medicine reconciliation has shown repeated success. Local Content The Patient Flow Workstream of the Sustainability Programme has already identified the need to overhaul discharge planning, discharge documentation (content and timeliness), and communication between hospital-based carers and those in residential and primary care settings. That work will be a specific focus for the planned discharge project in the first two quarters of the 2015/16 year. Alongside that it is imperative the quality of discharge documentation is improved. Enhancements to the electronic discharge summary, to make it easier to complete and reduce the need for duplicated transcription, are also planned for the 2015/16 financial year as part of the Information Technology workstream of the Sustainability Programme. It is imperative that the timeliness of communication with primary care is enhanced. The most obvious tactic to achieve that is to replace postal systems with electronic transmission of patient event and discharge information to GPs. Some innovative Canadian hospitals have now moved beyond those basic steps to create Virtual Wards in which primary care providers collaborate with secondary specialists to manage patients who are at high risk of readmission. These more innovative opportunities are equally applicable at, but the initial focus for improvement is getting back to the basics - communicating with patients, whānau and the professionals who contribute to their post-discharge care much more effectively. The plan to achieve these improvements, and report progress against them, will be reported to the SAC Committee of the Board as part of the Patient Flow Workstream over the next nine months. Conclusion Rates of unplanned readmission are an important quality indicator. s rate of readmission can and should be improved. Recent benchmarking indicates that has recovered from a negative spike in performance at the end of the year, however, further improvement is eminently achievable. The key to reducing readmission rates is the same as those for improving discharge. The local evidence is that there is considerable room to further improve how patients and their whānau are prepared for discharge, how post-discharge care is arranged and how primary care practitioners (nursing and medical) are communicated with so they can more effectively collaborate in post-discharge care. These issues will be progressively addressed through the Patient Flow Workstream of the Sustainability Plan over the course of the next nine months. Mark Spittal Group Manager & Thames Hospitals Page 6

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