Physicians in a discussionThroughout the nation, payers’ penalties to hospitals for readmissions are driving numerous initiatives to improve care transitions. South Carolina’s acute care facilities have come together to create a statewide quality improvement learning collaborative named Preventing Avoidable Readmissions Together (PART). Eligible participants include all acute care hospitals and home health organizations, nursing facilities, hospices, and other health care organizations. The results of PART’s initial 18 months (September 2012 to February 2014) are profiled in an article published ahead of print in Population Health Management (June 23, 2015) at http://online.liebertpub.com/doi/10.1089/pop.2014.0182). The authors include Patrick J. Cawley, M.D., Executive Director/CEO of MUSC Medical Center and Vice President for Clinical Operations at MUSC; and R. Neal Axon, M.D., Associate Professor in the Department Medicine at the Medical University of South Carolina.

The majority of the state’s acute care hospitals (92%) and hospital systems (90%) participated in collaborative events that included webinars and coaching calls, in-person meetings, and individualized peer consultations. The PART leadership team developed and distributed a resource guide to all interested organizations. Progress reports and outcomes analyses were also shared. At the completion of year one, 58% of participating hospitals completed a survey. Rates of implementation of the best practices that had been suggested were as follows: complete implementation of multidisciplinary rounds (58%), post-discharge telephone calls (58%), teach-back (32%), in-process implementation of high-quality transition records (53%), improved discharge summaries (45%), and timely follow-up appointments (39%). As for outcomes, a higher proportion of hospitals reported significant decreases in all-cause readmission rates for acute myocardial infarction, heart failure, and chronic obstructive pulmonary disease. The authors explain why certain readmission data should be interpreted with caution, and point out that the full effects of PART participation are probably not yet realized.