When leaders at Robert Wood Johnson (RWJ) University Hospital Hamilton, a 287-bed teaching hospital and member of Robert Wood Johnson Health System, looked at data from Crimson Continuum of Care, they were surprised to see the hospital’s average length of stay (LOS) and readmission rates for AMI and heart failure patients were higher than cohort benchmarks. What’s more, the LOS committee took a closer look at the performance data and found that discharge planning and care transitions were the major drivers of long patient stays and high readmission rates.
To get back on the right track, the team decided to work smarter at the point of care. From discharge instruction to patient education, they developed four aspects of better care, implemented this new work stream with dedicated transition nurses, and ultimately lowered readmission rates and decreased LOS.
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