Seven-Day Pledge at Cooper
Posted by Alexandra Lane, MD on March 16, 2018
The pledge to mitigate readmissions and better patient outcomes.
We have all been there. A patient comes for their hospital follow up visit two weeks after discharge. When you ask them if they finished their antibiotics, they ask ‘What antibiotics?’ Transitions of care tend to be a fraught time for our patients. Patients discharged from the hospital are settling back in to their home with new medications and new limitations—they may forget to pick up their antibiotics or lose the number for the wound care specialist or not understand the diagnosis that caused them to end up in the hospital in the first place. Unfortunately this can lead to readmissions and worsening health status.
What can we do to mitigate this problem? We can take the seven day pledge—a commitment to get every patient in for a follow-up appointment within seven days of discharge. This has been well studied as a solution to readmissions. The first study looked at the Medicare heart failure population in 2010 (1) and showed an inverse relationship between early hospital follow up and readmission rates. Since that time, multiple other studies have borne out the impact of seven day follow up on decreasing readmissions in heart failure and other chronic disease conditions (2-6). Devon Brackbill, Data Scientist in Population Intelligence, found the current average for follow up at Cooper is 11 days. As illustrated in Figure 1, bringing follow up time to seven days, we can cut down on 62 readmissions per year. So let’s all pledge to take on this challenge and provide timely care for better patient outcomes.
References:
1. Hernandez AF, Greiner MA, Fonarow GC, Hammill BG, Heidenreich PA, Yancy CW, Peterson ED, Curtis LH. Relationship Between Early Physician Follow-up and 30-Day Readmission Among Medicare Beneficiaries Hospitalized for Heart Failure. JAMA. 2010;303(17):1716–1722. doi:10.1001/jama.2010.533
2. Ryan J, Kang S, Dolacky S, Ingrassia J, Ganeshan R. Change in readmissions and follow-up visits as part of a heart failure readmission quality improvement initiative. Am J Med. 2013;126(11):989-994.e1.
3. Effect of Early Follow-Up After Hospital Discharge on Outcomes in Patients With Heart Failure or Chronic Obstructive Pulmonary Disease: A Systematic Review. Ont Health Technol Assess Ser. 2017;17(8):1-37.
4. Tung YC, Chang GM, Chang HY, Yu TH. Relationship between Early Physician Follow-Up and 30-Day Readmission after Acute Myocardial Infarction and Heart Failure. PLoS ONE. 2017;12(1):e0170061.
5. Baker H, Oliver-mcneil S, Deng L, Hummel SL. Regional Hospital Collaboration and Outcomes in Medicare Heart Failure Patients: See You in 7. JACC Heart Fail. 2015;3(10):765-73.
6. Jackson C, Shahsahebi M, Wedlake T, et al.Timeliness of outpatient follow-up: an evidence-based approach for planning after hospital discharge. Ann Fam Med 2015;13:115–22.
