Medina Healthcare System was recently chosen to present its project for the Texas Hospital Association’s (THA) Member Showcase Best Practices at the annual conference in Austin. Medina’s Vice President of Operations, Billie Bell, RN, led the project, which was entitled “Reducing Readmissions through a Community Approach to Care.”
“Our goal was to reduce readmission rates for Medina Regional Hospital and improve patient care through improved collaboration with our community partners, which included the Wesley Nurses and Community EMS,” said Ms. Bell. The hospital’s team included Bell, Chief Nursing Officer Rebecca Hinojoza, RN, Case Manager Rachel Cortez, RN, and Emergency Department Director Ronda Cote, RN. The hospital staff developed assessment tools to identify high risk patients. The team and the ED staff worked with Michael Haynie at Community EMS and Wesley Nurses Janet Crain, RN in Hondo, and Melissa Niemitz, RN in Devine to develop a referral system for post-discharge care. Community EMS personnel or a Wesley Nurse would follow up with a patient to assist with post-discharge issues such as medication compliance and referrals for additional social services.
Through this collaborative approach to care, readmissions (patients who had a second hospital stay within 30 days) decreased from 13 percent in September 2015, to a median of 4.66 percent in April 2016. Patient satisfaction scores also increased. Working with valuable community partners to provide ongoing care coordination services is another way Medina Healthcare System provides quality care close to home.