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The STAAR Initiative's work in Massachusetts, Michigan, and Washington is funded through a generous grant provided by The Commonwealth Fund.
 
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Materials

 

 

 

STAAR Overview Documents


 
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.
 
Effective Interventions to Reduce Rehospitalizations: A Survey of the Published Evidence
This document is a survey of the published literature regarding the effective interventions to reduce avoidable rehospitalizations.
 
Effective Interventions to Reduce Rehospitalizations: A Compendium of 15 Promising Interventions
This companion document to the Survey of the Published Evidence provides information regarding current best programs and practices to reduce rehospitalizations.
 
 

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.
 
How-to Guide: Improving Transitions from the Hospital to Community Settings to Reduce Avoidable Rehospitalizations
This How-to Guide is designed to support hospital-based teams and their community partners in codesigning and reliably implementing improved care processes to ensure that patients who have been discharged from the hospital have an ideal transition to the next setting of care (such as a primary care practice, home care, or a skilled nursing facility).
 
How-to Guide: Improving Transitions from the Hospital to Skilled Nursing Facilities to Reduce Avoidable Rehospitalizations
This How-to Guide focuses on the transfer of patients to skilled nursing facilities (SNFs), an umbrella term that includes nursing homes, long-term care facilities, acute rehabilitation facilities, and post-acute care facilities. The guide highlights four promising changes for an ideal transition and several other changes that merit further testing. Key tools and resources to help organizations implement these changes are also included.
 
How-to Guide: Improving Transitions from the Hospital to Home Health Care to Reduce Avoidable Rehospitalizations
This How-to Guide is designed to support hospital-based teams and their community partners in creating an ideal reception into home health care in the first 48 hours after the patient is discharged from the hospital, a post-acute care setting, or a rehabilitation facility.
 
How-to Guide: Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations
This How-to Guide focuses on the reception of patients back into the office practice after hospitalization and is intended to be a resource for clinicians and staff in office practices as they create new ways to provide optimal care for their patients.
 
 

Tools


 
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.
 
 

STAAR Issue Briefs


 
Issue Briefs are published periodically to provide detail on learnings to date in the STAAR Initiative.
  • Cross-Continuum Teams
 
 

WIHI


 
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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Presentations


  
STAAR Minicourse Slides: Reducing 30-day Rehospitalizations in a State or Region (December 2010)
Presented at IHI's 22nd Annual National Forum on Quality Improvement in Health Care in Orlando, Florida, on December 6, 2010.
 
STAAR Minicourse Slides: Decreasing Avoidable 30-Day Rehospitalizations (December 2009)
Presented at IHI's 21st Annual National Forum on Quality Improvement in Health Care in Orlando, Florida, on December 7, 2009.
 
STAAR Webinar: The Financial Impact of Readmissions (May 2010)
Part 1: The STAAR Approach 
Part 2: Lessons from the Field
 
 

Videos


Rebecca Bryson's Story: Excerpt from 2002 IHI National Forum Keynote Address by Maureen Bisognano
 
IHI Media Player
Silverlight web part for playing Audio and Video files
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Related Information



Read the March 2010 HealthLeaders Media article on reducing readmissions.
 
View the UPMC St. Margaret video on reducing 30-day COPD readmissions.
 
 
  

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.