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Patient Safety
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Through the Quality Improvement Organization (QIO) Program, 14 communities across the country have improved coordination across health care settings and equipped Medicare beneficiaries to take a more active role in managing their health after a ospitalization. These communities’ achievement in reducing avoidable hospital readmissions within 30 days of patient discharge demonstrate what every community with the will to improve can accomplish. Their success also has established a foundation for related, future QIO Program initiatives.
Bringing best practices to the beneficiary QIOs in every state and territory, united in a national network administered by the Centers for Medicare & Medicaid Services, have the ability to focus health care quality improvement resources and expertise at the community level. This was especially critical to the success of the Care Transitions initiative. With community participants, QIOs implemented three types of interventions to promote seamless transitions between care settings and reduce hospital readmissions: improving processes of care at a system level, identifying specific diseases or conditions that lead to readmissions, and addressing community-specific reasons for readmissions. QIOs also worked with providers and community partners to open a dialogue and support greater coordination among the multiple providers who treat patients with chronic illnesses. Additionally, they coached Medicare beneficiaries and their caregivers about local resources to help them stay healthy and take greater control of their own health care decisions.
Download a brochure on the new QIO Patient Safety Initiative.
In the State of Washington, for example, the QIO empowered Medicare beneficiaries to take an active role in their own care by providing care transitions coaching. One patient had been hospitalized 9 times in 13 months due to a chronic condition, mismanaged medications and a general lack of knowledge about community resources. When a transitions coach was integrated into the care plan and his caregiver joined the team for additional support, the beneficiary was able to stay out of the hospital for seven months.
Contributing to national health quality goals Avoidable hospital readmissions cost Medicare an estimated $12 billion annually. From August 2008 through July 2011, more than 1,125,500 Medicare beneficiaries were affected by the QIO Program’s community-based initiatives to reduce avoidable hospital readmissions. In total, the 14 participating communities reduced admissions per 1,000 beneficiaries by 5.6%, compared to a 3.4% reduction in 52 peer communities.
Building on success, aiming even higher
Moving forward, QIOs will bring together hospitals, nursing homes, patient advocacy organizations and other stakeholders in communities with high hospital readmission rates. The goal is to help these communities build capacity for comprehensive, coordinated approach to care transitions that will qualify them for funding through Section 3026 of the Affordable Care Act.
For more information
The QIO Program invites all health care providers and health quality stakeholders—including patients and their families—to be a part of its new Care Transitions initiative. To express an interest, contact your local QIO. A directory is provided in the Program’s “Advances in Quality” report. More information also is available at www.cms.gov/qualityimprovementorgs\.
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All information on this site is provided as a public service only and should not be relied upon as medical or legal advice. Some of the information included in this site was obtained through work performed under a contract with the Centers for Medicare & Medicaid Services, Department of Health and Human Services. SDFMC shall not be held liable for any damages arising from the use of or reliance upon information supplied herein. Any links to other organizations contained on this site are for informational purposes only and do not imply endorsement by SDFMC.
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