Preventing Avoidable Hospital Admissions

Topics: Nursing, Readmissions, Quality, Performance Improvement

After reading this study, members will understand:

• Why it will be increasingly important to prevent unnecessary hospital admissions
• Why hospital executives should further invest in primary care
• Key pitfalls administrators commonly fall into when investing in primary care models
• Five primary care strategies for preventing avoidable hospital admissions

Executive Summary

The growing number of patients with chronic conditions likely to experience an acute care episode and require hospitalization comprises a formidable threat to hospital finances. The total costs for caring for such patients already outpaces the level of inpatient reimbursement hospitals typically receive, and payment reforms now taking root are likely to exacerbate this shortfall. Fortunately, mounting evidence suggests many hospital admissions for chronic disease patients are avoidable, and targeted investment in new primary care models can prevent them. But in light of the sheer number of ideas, models, and variants now sweeping the industry, determining what constitutes the optimal investment for a given institution is no easy task.

To help hospital-based nurse executives play an active role in guiding primary care investment decisions, the Nursing Executive Center offers an executive framework for weighing options against five strategies critical to preventing unnecessary acute care episodes. The first two strategies focus on improving clinicians’ ability to deliver more comprehensive care to patients with treatable chronic conditions. The remaining three focus on activating patients in their own health or care management.

The Alarming Economics of Chronic Care