Rethinking transitions of care: An interprofessional transfer triage protocol in post-acute care

• Published in: Journal of interprofessional care 2017-09, Vol.31 (5), p.648-651
• Main Authors: Patel, Radha V, Wright, Lauri, Hay, Brittany
• Format: Article
• Language: English
• Subjects: Acute services; Admissions policies; Clinical decision making; Clinical Protocols; Communication; Health care expenditures; Hospitalization; Humans; Inservice Training - organization & administration; Interdisciplinary aspects; Interprofessional Relations; Length of Stay; Long term health care; Long term hospitals; Medical screening; Patient admissions; Patient Care Team - organization & administration; Patient Care Team - standards; Patient Readmission - statistics & numerical data; Patient Transfer - organization & administration; Patient Transfer - standards; Penalties; Pilot Projects; Qualitative research; Quality Improvement; Quality of care; Quantitative analysis; Readmission; Subacute care; Subacute Care - organization & administration; Triage; Triage - organization & administration; Triage - standards
• ISSN: 1356-1820; 1469-9567
• DOI: 10.1080/13561820.2017.1324831

Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation. Results from quantitative analysis demonstrated an overall 35.2% reduction in the 30-day preventable hospital readmission rate. Qualitative analysis revealed the need for additional staff education, improved screening and communication upon admission and prior to hospital transfer, and the need for more IPT on-site availability. This pilot study demonstrates the benefits and implications for practice of an IPT to improve the quality of care within PAC and decrease 30-day preventable hospital readmissions.