NR 706 Week 6 Practice Problem Analysis PowerPoint

NR 706 Week 6 Practice Problem Analysis PowerPoint

Student Name

Chamberlain University

NR-706: Healthcare Informatics & Information Systems

Prof. Name

Date

PICOT Question

Does frequent rounding and close monitoring of newly admitted patients in post-acute care settings, compared to current guideline recommendations, decrease hospital readmission rates over an 8-week period?

The PICOT framework provides a systematic approach for developing clinical questions and designing evidence-based interventions. This structured format enables healthcare professionals to identify clinical issues, evaluate possible interventions, and measure outcomes effectively. By defining each component—Population, Intervention, Comparison, Outcome, and Timeframe—clinicians can develop targeted and testable strategies that enhance patient care.

PICOT Elements

The following table outlines the individual components of the PICOT framework applied to this study:

This framework assists healthcare teams in evaluating whether enhanced monitoring and early intervention practices can reduce unnecessary hospital readmissions among post-acute patients.

Post-Acute Rehospitalization Rate Reduction

Hospital readmissions continue to be a significant concern in post-acute care environments, contributing to both financial and clinical challenges. Rehospitalizations are estimated to cost nearly $40 billion annually, and research indicates that 5% to 79% of these cases may be preventable (Harris et al., 2018). A modest 10% reduction in readmissions could lead to savings exceeding $1 billion per year.

In addition to financial implications, patients who experience repeated hospitalizations endure extended recovery periods, increased infection risks, and a decline in independence. These challenges contribute to emotional distress, functional decline, and a reduced quality of life. Therefore, implementing proactive strategies aimed at preventing readmission is essential for improving patient outcomes (Harris et al., 2018).

Restated PICOT Application

Does frequent rounding and oversight by clinicians reduce hospital readmission rates compared to current practice guidelines over an 8-week period for patients recently discharged to post-acute care?

This refined question further emphasizes clinician involvement in continuous patient observation and highlights the timeframe necessary to evaluate intervention outcomes.

Key Strategies to Address the Problem

Several evidence-based strategies can help reduce hospital readmissions in post-acute settings:

• Conducting comprehensive assessments and frequent follow-ups by clinicians and nursing staff

• Detecting potential complications early through close observation

• Comparing frequent rounding against guideline-based care models

• Tracking readmission rates within an 8-week period to measure success (March & Mennella, 2018)

Discharge to Community–Post-Acute Care (DTC-PAC) Measures

To promote quality care and reduce avoidable readmissions, the Centers for Medicare & Medicaid Services (CMS, 2019) introduced standardized performance measures following discharge.

These measures balance patient safety with cost-effectiveness and underscore the importance of minimizing preventable readmissions.

Hospital Readmission Reduction Program (HRRP)

The Hospital Readmission Reduction Program (HRRP) focuses on six key clinical conditions to standardize evaluation of 30-day readmission rates and improve patient outcomes (Hatipoğlu et al., 2018):

• Acute Myocardial Infarction (AMI)

• Congestive Heart Failure (CHF)

• Pneumonia

• Coronary Artery Bypass Graft (CABG)

• Chronic Obstructive Pulmonary Disease (COPD)

• Elective total hip or knee arthroplasty

By linking reimbursement to performance on these conditions, HRRP encourages healthcare organizations to implement evidence-based interventions and reduce avoidable hospital returns.

A New Approach: Meaningful Outcomes

Reducing rehospitalizations in post-acute care requires a collaborative, patient-centered model focused on improving outcomes. The following components support this approach:

• Shared decision-making between patients and clinicians using evidence-based care

• Flexibility for state and local systems to design innovative care models

• Strategies that enhance affordability, accessibility, and overall quality of care

• Prioritization of preventive care and early interventions to minimize costly complications

This approach promotes sustainable healthcare improvements while enhancing patient well-being.

Failure Modes and Effects Analysis (FMEA)

Failure Modes and Effects Analysis (FMEA) serves as a proactive method for identifying potential risks that contribute to readmissions.

This analysis demonstrates that improving communication, timeliness of assessments, and consistency in rounding can significantly reduce rehospitalization rates (Harris et al., 2018).

Ishikawa (Fishbone) Diagram Factors

Several systemic and operational factors contribute to increased readmission rates in post-acute care (LUCA, 2016; March & Mennella, 2018):

• Medical doctors and ARNPs: Variations in follow-up frequency and continuity of care

• Skilled nursing facilities: Inconsistent rounding and monitoring practices

• Electronic Medical Records (EMR) systems: Inefficiencies or errors in software such as PointClickCare and Gherimed

• Monitoring gaps: Delayed recognition of patient deterioration due to inadequate assessments

These factors indicate that addressing system-level challenges is equally vital as improving individual clinician performance to achieve lasting reductions in readmission rates.

Conclusion

Frequent rounding and vigilant monitoring in post-acute care environments provide significant clinical and financial advantages. Such interventions allow for early detection of clinical deterioration, timely treatment, and reduced hospital readmissions. Patients benefit from improved recovery outcomes, enhanced quality of life, and sustained independence.

From a system perspective, proactive monitoring strategies promote cost savings and sustainable resource allocation. The evidence supports that consistent and structured rounding models not only improve patient safety but also strengthen healthcare efficiency (UpToDate, 2019; Agarwal & Werner, 2018).

References

Agarwal, D., & Werner, R. M. (2018). Effect of hospital and post-acute care provider participation in accountable care organizations on patient outcomes and Medicare spending. Health Services Research, 53(6), 5035–5056. https://doi.org/10.1111/1475-6773.13023

Centers for Medicare & Medicaid Services. (2019). Skilled Nursing Facility 30-Day Potential Preventable Readmission Measure (SNFPPR). https://cmit.cms.gov/CMIT_public/ViewMeasure?MeasureId=2801

Harris, C., Garrubba, M., Melder, A., Voutier, C., Waller, C., King, R., & Ramsey, W. (2018). Sustainability in health care by allocating resources effectively (SHARE) 8: Developing, implementing, and evaluating an evidence dissemination service in a local healthcare setting. BMC Health Services Research, 18(1), 151. https://doi.org/10.1186/s12913-018-2977-3

NR 706 Week 6 Practice Problem Analysis PowerPoint

Hatipoğlu, U., Wells, B. J., Chagin, K., Joshi, D., Milinovich, A., & Rothberg, M. B. (2018). Predicting 30-day all-cause readmission risk for subjects admitted with pneumonia at the point of care. Respiratory Care, 63(1), 43–49. https://doi.org/10.4187/respcare.05719

LUCA, L. (2016). A study on quality analysis measuring process. Fiability & Durability, 2, 68–72.

March, P. P., & Mennella, H. D. A.-B. (2018). Quality improvement in long-term care. CINAHL Nursing Guide.

UpToDate. (2019). Hospital discharge and readmission. https://www.uptodate.com/contents/hospital-discharge-and-readmission