Resilience as a SOLUTION to Reduce Readmissions?

Let’s go back to what we’ve established:

*There are new CMS expectations on readmission rates, and financial penalties will drop on hospitals if they don’t reduce readmissions.

*Drug Abusers tend to go back to the Hospital after another bout of overdose, or serious drug reaction, thereby increasing hospital readmission rates.

*CMS believes a strong Discharge Plan should reduce readmissions.

*CMS has not assigned concrete ownership to the driver of the Discharge Planning process.

*Social Workers and Nursing clash over which skill set should drive discharge planning. This infighting could be a symptom of larger issues including, but not limited to, leadership management problems, unclear mission/vision/values, performance issues, poor morale, and/or lack of trust among colleagues.

*This is a small problem that could become a disaster if hospitals do not address and remedy readmission rates, especially those of drug abusers.

According to organizational theorists Sutcliffe and Vogus, “resilience refers to the maintenance of positive adjustment under challenging conditions.” Indeed, resilience refers to organizations that can improve despite stress and strain. It’s also about organizations’ abilities to use internal resources successfully.

It’s inevitable that CMS will financially penalize hospitals that don’t meet the challenge of providing best care at lower cost; that don’t reduce readmissions through better discharge planning. These financial penalties will hit hard causing perhaps a financial crisis in hospitals that have drug abusers’ readmissions.

How can hospitals prepare to successfully, and with sustainability, reduce readmissions, and that of drug abusers, in particular? Better discharge planning, with nursing as the driver, could work if the organization has addressed the culture clash between nursing and social work in the discharge planning process.

Use a few of the resiliency factors that have proven successful for other organizations that have experienced crises. Even in a potential crisis situation, these factors are powerful to mitigate a crisis.

*Establish and maintain strong values, mission, vision- that this is all about patient safety, not money.

*Use internal resources effectively: put nursing in charge of this project, with development, implementation and primary oversight of social workers.

*Establish a redundancy system: With nursing as the primary driver of discharge planning, work alongside with social workers so that this skill set can fill in as the substitute driver if this task needs to carried out if the nurse is absent. This adaptability will bode well in the long run for the hospital.

*Establish a learning, non-punitive culture, emphasized by top management, that will serve to meet difficulties associated with potential crises.

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