28 day readmission reduction project
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28 Day Readmission Reduction Project. Presenters Mary Hyland, Barwon Wendy Hoey, Rockhampton Michael Finn, Fremantle Fiona Whitecross, Bayside. National Mental Health Benchmarking Project 27 November 2008. NMHBKPI Project Adult Participant Group. . Rockhampton, QLD. Fremantle MHS,

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28 Day Readmission Reduction Project

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28 day readmission reduction project

28 Day Readmission Reduction Project

Presenters

Mary Hyland, Barwon

Wendy Hoey, Rockhampton

Michael Finn, Fremantle

Fiona Whitecross, Bayside

National Mental Health Benchmarking Project

27 November 2008


Nmhbkpi project adult participant group

NMHBKPI Project Adult Participant Group

Rockhampton, QLD

Fremantle MHS,

WA

Blacktown,SWSMHS

St George, SESIMHS

Noarlunga,

SA

ACT Health

Bayside Health, VIC

Barwon Health, VIC

National Mental Health Benchmarking Project 27 November 2008


Background to 28 day readmission reduction project

Background to 28 day readmission reduction project

  • Sub-project of NMHBKPI project

  • Team selected from interested NMHBKPI participants

  • Explore 28 day readmission KPI in more detail and

  • Develop best practice guidelines for reducing risk of readmission

National Mental Health Benchmarking Project 27 November 2008


Methodology

Methodology

  • Literature Review

  • Site visits x 4

  • Opinion Pieces

National Mental Health Benchmarking Project 27 November 2008


Key findings from the literature

Usefulness:

Potential key performance indicator

Must be interpreted with caution

The KPI is sensitive to the time period chosen.

Factors that influence readmission rates:

Age and gender

Ethnicity

Diagnosis

Level of functioning

Severity & persistence of symptoms

Stress and psychosocial problems

Psychiatric services history

Other clinical factors

Housing

Socio-economic status

Family/social support

Key Findings from the Literature


Key findings from the literature cont d

Service based factors:

Bed occupancy

Length of stay

Discharge planning

Community follow-up and support

Medication issues

Strategies for reducing readmission rates

Improved discharge planning

Improved community follow-up and support

Key Findings from the Literature (cont’d)


Opinion piece framework

Opinion Piece Framework

  • Describe service model

  • General population and client characteristics,

  • Housing options,

  • Bed management system,

  • Discharge processes,

  • Clinical staff opinion on 28 day readmission rate,

  • Client opinion on 28 day readmission rate

  • Carer opinion on 28 day readmission rate

  • Staffing and skill mix,

  • 5 major diagnostic categories of admission and readmission.

National Mental Health Benchmarking Project 27 November 2008


Key findings from the opinion pieces

Key Findings from the Opinion Pieces

  • Contextual Information

  • Views of the KPI as useful

  • Factors affecting the readmission rate

  • Consumer-based factors

  • Service based factors

  • Strategies for reducing the readmission rates


28 day readmission reduction project site visits

28 day readmission reduction project – site visits

Rockhampton, QLD

Noarlunga, SA

St George, NSW

The Alfred, VIC

National Mental Health Benchmarking Project 27 November 2008


Site visits interview framework and question prompts

Site visits interview framework and question prompts

  • Business rules and governance

  • Interface between inpatient and ambulatory services

  • Consumer flow decisions

  • Discharge planning

  • Purpose of admission/readmission

  • Length of stay, occupancy and readmission

  • Illness Influences

National Mental Health Benchmarking Project 27 November 2008


Strengths and limitations

Strengths and Limitations

  • Strengths:

    • Combined scientific evidence with expert opinion

    • Services involved were a broad representation of Australian MHS

    • Examined several services already moving towards best practice in action

  • Limitations

    • “Gaps” in the literature

    • Subjectivity and bias within opinion pieces

    • Selection bias in sites chosen


Towards 28 day readmission reduction best practice guidelines

Towards 28 day readmission reduction best practice guidelines

  • Good governance comes with strong clinical leadership

  • Consumer engagement crucial

  • Engagement with family and carers

  • Seamless service delivery

  • Proactive resource management systems

  • Systematic discharge planning practices

  • Active and timely community follow-up

National Mental Health Benchmarking Project 27 November 2008


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