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Veterans administration Pittsburgh healthcare system veterans engineering resource center: reducing readmissions through health systems engineering methodologies at the veterans health administration

Ketterer, Ashley (2015) Veterans administration Pittsburgh healthcare system veterans engineering resource center: reducing readmissions through health systems engineering methodologies at the veterans health administration. Master Essay, University of Pittsburgh.

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Abstract

Hospital readmissions are significant to Public Health because of the growing need for improved quality with minimal resources. Readmissions that occur within 30 days of a hospital discharge decrease access care, as indicated throughout the paper, and waste clinical resources in acute care inpatient hospitals. The 30 day all cause readmission rate (30 DRR) was 15.5% for Fiscal Year 2014, Quarter 1 at the Veterans Administration Pittsburgh Healthcare System (VAPHS) University Drive (UD) campus, and the National goal is to decrease the national rate by 5%. The VAPHS Veterans Engineering Resource Center (VERC) is leading a facility-wide quality improvement project to reduce the 30 DRR. The project consists of three inpatient and outpatient pilot studies, utilizing health systems engineering methodologies to improve the processes related to admission, discharge, and post-discharge management. Multidisciplinary work groups utilized process improvement tools to identify areas that were relevant to VAPHS. Literature reviews were completed to identify best practices and strategies for improvement. The strategies for improvement were organized in a matrix and prioritized by feasibility and impact. The three areas with highest impact and identified feasibility were post-discharge follow-up appointments, medication reconciliation, and disease specific education. Each strategy was tested in the medicine patient population at different time intervals to ensure patients did not receive multiple strategies. The appointment scheduling pilot showed a 10% decrease in readmissions. The medication reconciliation pilot did not have a statistically significant sample size, but found that 59% of patients had a medication discrepancy. The patient education pilot showed a 14% decrease in readmissions in the Congestive Heart Failure, Pneumonia, Renal Disease, Diabetes, and Chronic Obstructive Pulmonary Disease (COPD) disease populations. The literature suggests that bundling these three strategies and providing them to patients at the same time would have a greater impact on reducing 30-day readmissions and improving transitional care measures than would any strategies individually.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ketterer, Ashley
Date: April 2015
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: readmissions, care, transitions, medication, reconciliation, patient, education, appointment, scheduling
Date Deposited: 19 Oct 2015 16:03
Last Modified: 20 Dec 2018 00:56
URI: http://d-scholarship.pitt.edu/id/eprint/24201

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