Reducing readmissions: Top strategy for improving quality, lowering costs

Hospital readmissions cause a heavy financial burden on the healthcare system and should be the top priority of healthcare organizations for improving quality and lowering costs, according to a new online survey of 300 quality improvement professionals conducted by ASQ, a network of quality resources and experts. 

Aside from reducing readmissions, Joseph Fortuna, MD, immediate past chair of ASQ's Healthcare Division, says there are four additional action steps that healthcare organizations should be taking to raise quality and lower costs:

• Reducing hospital readmissions;

• Maximizing efficiency with existing clinical resources (staff and units); 

• Implementing patient care coordination; 

• Redesigning the healthcare delivery model to include alternatives to physician deliver of primary care; and

• Improving data and analytics on return on investment of medical products/technology.

Because there are also a number of hurdles often faced when trying to implement these action steps, Dr. Fortuna says that there must be buy-in at every level of the organization for these initiatives to have long-term impact.

Dr. Fortuna says payers should consider expand their perspectives on improving the healthcare system by adopting the use of the tools, methodologies and quality improvement professionals (engineers) that other industries have with great success as recommended in the May report of the President’s Council of Advisors on Science and Technology (PCAST). Incenting providers to do the same would also assist in the effort to remove waste and improve operations, culture and clinical care.

The co-chairs of the report state:

“Systems engineering-widely used in manufacturing and aviation-is an interdisciplinary approach to analyze, design, manage and measure a complex system in order to improve its efficiency, reliability, productivity, quality and safety. It has often produced dramatically positive results in the small number of healthcare organizations that have incorporated it into their processes. But in spite of excellent examples, systems methods and tools are not yet used on a widespread basis in U.S. healthcare.”

Dr. Fortuna says the industry needs to get on the bandwagon by utilizing systems and process improvement engineers instead of relying on second team players.

"The stakes are too high; the need is urgent," he says. 

Additionally, Dr. Fortuna says that incentives in healthcare must change to align more with what all stakeholders would like as outcomes. 

"Waste in healthcare, estimated to be as high as $1 trillion, needs to be eliminated," he says. "Achieving this could fund a lot of care."