"During the first eight months of this year, fewer than 18 percent of Medicare patients ended up back in the hospital within a month of discharge, the lowest rate in years, the federal government reported." The decline in the number of rehospitalizations occurred as Medicare began penalizing hospitals for high readmission rates. Although many in the medical community were skeptical of the effectiveness of such penalties, Medicare has touted the fact that "three out of every four local hospital markets experienced a decrease in readmission rates of a half-percent or more" as a result of the new penalty structure.
A new study published in Health Affairs indicates that emergency room type 1 observation units have the potential to cut healthcare costs by $1 billion a year and reduce readmission rates. "Type 1" units are those that are "dedicated specifically to observation with clearly defined protocols." The study showed that patients in these units see significantly lower readmission rates. The effectiveness of observation status has repeatedly been called into question this year.
The physicians at Saint Francis Memorial Hospital in San Francisco have been recognized in Today's Hospitalist for their integration efforts between the ED and the inpatient department. Quarterly staff meetings and regularly scheduled joint meetings have been the keys to the hospital's success. Saint Francis now sees "a median time-to-provider of less than nine minutes and a turnaround time-to-discharge from the ED of less than two hours." In September, the hospital was named Vituity's 2013 Practice of the Year at its annual Partnership Meeting in Los Angeles. "The ER-hospitalist collaboration is why we won site of the year," said Joseph Mallon, MD, Saint Francis' Hospitalist Medical Director. "There's definitely a mutual respect for each other's time and opinion."