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Mercer County Hospital Readmission Rate Falls After Trenton Health Team-led Effort

TRENTON – Coordination between the Trenton Health Team, local hospitals and nursing homes is slowly lowering Mercer County’s hospital readmission rates, Trenton Health Team officials said last week.

Between 2011 and mid-2012, 30-day hospital readmission rates for the county’s four hospitals dropped by 6.8 percent, according to a news release by the Trenton Health Team (THT).

The organization is a partnership between Capital Health, St. Francis Medical Center, Henry J. Austin Health Center and the city and works to increase health and health-care access in low-income Trenton.

Two years ago, local hospitals began looking internally to cut down on the number of avoidable hospital readmissions, which can result in costly Medicare penalties and prove stressful for patients and their families, said Dr. Robert Remstein, THT president and vice president for accountable care at Capital Health.

Collectively, county hospitals had less-than-stellar 30-day readmission rate numbers, ranking 16 out of the state’s 21 counties in 2009.

“It reduces complications,” Remstein said. “People don’t like to go into the hospital at 2 a.m. from the nursing home and people don’t like to get a call in the middle of the night that mom’s going back to the hospital.”

So teams looked at what patients were being readmitted for the most – lung disease, dialysis and heart-failure patients topped the list – and studied ways to prevent them from rapidly cycling in and out of hospitals.

Hospital discharge staff double-check medications to be sure a patient isn’t going home or back to a nursing facility without the right dose. Nursing home staff are better trained to recognize when a visit to the ER is really needed and nursing facilities are being pushed to add more advanced nurses to increase the level of care for patients and prevent complications that could send them back to the hospital, Remstein said.

“It’s more than a dollars and cents thing,” he said. “It really comes down to what’s best for the patient.”

Trenton Health Team members are reaching out to local churches and other community organizations to educate people about palliative and hospice care and when it might be time to try a less aggressive treatment for very ill patients.

“We haven’t seen an increase in mortality, we’re not denying care, it’s just appropriate provision of care,” Remstein said.

The Trenton Health Team tracked the readmission numbers with the help of Healthcare Quality Strategies Inc., the Medicare-designated Quality Improvement Organization for the state, which oversees quality and effectiveness of care delivered to Medicare patients.

The Trenton Health Team is hoping to reduce the current readmission rate from 20.2 percent to 17.1 percent by the end of the year. Mercer County’s state ranking for readmission rates has since dropped to 13 out of 21.

About the Trenton Health Team
Trenton Health Team (THT) is an alliance of the city’s major providers of healthcare services including Capital Health, St. Francis Medical Center, Henry J. Austin Health Center and the city’s Health Department. In collaboration with residents and the city’s active social services network, THT is developing an integrated healthcare delivery system to transform the city’s fragmented primary care system and restore health to the city. THT aims to make Trenton the healthiest city in the state. Support for the Trenton Health Team was provided in part by a grant from The Nicholson Foundation. For more information, visit www.trentonhealthteam.org.

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