STAAR: A State-Based Strategy to Reduce Avoidable Rehospitalizations
This foundational document is a summary of IHI’s work to develop a state-wide strategy for reducing avoidable rehospitalizations prior to STAAR. This work led to the production of materials to highlight promising approaches to reduce avoidable rehospitalizations and directly informed the scope of the STAAR initiative.
How-to Guides and Guides for Field Testing
These resources were created to support organizations in their work to improve transitions in care as part of the STAAR initiative and beyond. The How-to Guide includes changes that have been tested and are foundational to the initiative. The Field Guides include ideas and potentially effective changes that have been discovered through STAAR but have not yet been tested.
Agenda-Setting Communication Cards for CHF Patients
Cedars-Sinai Medical Center in Los Angeles, California, has adapted a set of "agenda-setting cards" to improve discharge communication for patients with congestive heart failure (CHF). Each card in the deck has a question that heart failure nurses have gathered from their patients. The agenda-setting cards reduce hesitation to ask questions and assist patients with driving the learning agenda. Patients are given the card deck to keep and are encouraged to choose 2 to 3 cards for discussion at each learning opportunity across care settings. To date, the cards have been very successful in the hospital and ambulatory settings.
STAAR Readmissions Diagnostic Worksheets
This tool helps hospitals perform an in-depth review of the last five rehospitalizations to identify opportunities for improvement. This includes conducting chart reviews of the last five readmissions as well as interviews with recently readmitted patients and their family members.
A Tool for State Policy Makers
The checklist provided in this tool focuses on aspects of the health care system that policy makers can influence and for which data is available to assess their state’s performance regarding hospital readmission rates.
Issue Briefs are published periodically to provide detail on learnings to date in the STAAR Initiative.
One of the tools that STAAR uses to reach new audiences is WIHI, an exciting "talk show" program from IHI. It’s free, it’s timely, and it’s designed to help dedicated legions of health care improvers worldwide keep up with some of the freshest and most robust thinking and strategies for improving patient care.
Breaking the Cycle of Readmissions
Date: May 7, 2009
Featuring: Amy Boutwell, MD, MPP, Director of Health Policy Strategy, IHI; Thomas H. Lee, PhD, CEO, Partners Community Healthcare, Inc.
No one welcomes a return trip to the hospital once you’ve been sent home. And that’s certainly not what health care providers intend. Yet, for a significant number of patients, bouncing back into the hospital happens all too frequently — for costly reasons that could be better anticipated and avoided. So, what to do, especially in a notoriously fragmented system?
Listen to a recording of the program.
Reducing Readmissions, Restoring Revenues: Making Good Care Count
Date: October 7, 2010
Featuring: Amy Boutwell, MD, MPP, Director of Health Policy Strategy, IHI; Jeffrey Burke, Director, Financial Decision Support, Spectrum Health; Rosemary Rotty, Director, Financial Planning, UMass Memorial Health Care
Even as payers, including Medicare, are poised to make hospitals that don’t reduce their readmissions feel added financial pain, the fiscal impact on hospitals doing the right thing, right now, is already real. At times, it feels like it comes down to “choose your poison.” That’s why, experts say, hospitals have often made the unbelievable decision of throwing successful readmission reduction programs overboard, quite simply because they can’t afford the negative effect on the bottom line. The STAAR initiative is taking a hard look at finances, working with a courageous group of hospitals that are learning how to open their books and analyze their admissions (and readmissions) patterns with some new eyes and new thinking.
Listen to a recording of the program.
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Rebecca Bryson's Story: Excerpt from 2002 IHI National Forum Keynote Address by Maureen Bisognano
Getting Started in Reducing Avoidable Readmissions Webinar Series
IHI conducts a series of "Getting Started" webinars to assist participating hospitals in preparing for their participation in the STAAR Collaborative.