Last week, the the CMS (Center for Medicare & Medicaid Services) released its Overall Hospital Quality Star Ratings despite pressure from hospitals to continue to delay the release. While there may be well over 25 blog topics one could cover related to this report and its already postponed release, I would like to draw attention to one important data piece: patient education.
Readmission rates (when patients are sent back to the hospital after discharge) are costing the already-strained health care system too much money, which is why CMS is no longer reimbursing for readmissions related to hospital-acquired infections.
Yet patients are returning for other reasons—including issues related to not following discharge instructions at home. That means that in order to decrease readmissions, it’s imperative that patients understand their discharge instructions and how to care for themselves after they leave the hospital. Unfortunately, that education piece isn’t happening. And it’s easy to guess why: When hospitals don’t schedule enough nurses for duty, nurses all too often have to choose between rescuing a patient from falling or focusing on discharge education.
The CMS survey asks patients three questions, including: “Did you and or your caregivers understand what you would have to do to take care of yourself after leaving the hospital?” Of the hospitals I looked up, mostly Allina hospitals, none scored over 59 percent on this subject. So almost half the patients discharged from Abbott Northwestern, United, Mercy, and Unity hospitals do not know how to care for themselves post discharge.
As nurses, we know educating patients on how to care themselves is one of the most important tools nurses can give patients—and it’s the one they continually rely on nurses to do. Yet in order to provide patients with the self-care education they need, there needs to be enough Rn’s with enough time dedicated to teaching and discharge instructions.
If hospitals really want to decrease their readmission rates—and the penalties that come with them– they need to invest in nurses, ensuring there is the right number of nurses to care for the patients on a unit at one time. Maybe CMS should add ”hospital understaffing” to the list as a reason to not reimburse, , right along with hospital-acquired infection Suggested new code reads: “Payment denied: Patient readmitted because of lack of knowledge on self-care post discharge from previous hospitalization.”
By Carrie Mortrud, RN, Minnesota