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Reducing Hospitalizations, 30-day Unplanned Readmissions and ER visits Quality Improvement Activity (QIA)


The 2020 USRDS Annual Data Report (ADR) Chapter 4: Hospitalizations, Readmissions, Emergency Department Visits and Observation Stats reports patients initiating hemodialysis had a higher rate of hospitalization in the first year followed by a gradual decline, while patient initiating peritoneal dialysis had a lower initial hospitalization rate that increased over the first 3 years and then stabilized. 

Decreasing rates of hospitalizations, unplanned 30-day readmissions and emergency department (ED) visits are challenging tasks. Evidence indicates people with unmet social determinants of health (SDH) influence individuals’ ability to attain their full health potential, leading them to consume more health care services or require more intensive health care than those without SDH1.  It is also true that people with depression utilize the services of the ED at a higher rate than those without depression. 

There are tools and strategies that can be effective at addressing the barriers that underlie these outcomes and it is not easy work. Many of the causes are outside the control of the dialysis clinic, yet we must find a way forward, where possible, using a multipronged approach which includes patient feedback as part of the QIA process. Below are resources and strategies to consider using for this QIA.

QIA Goals and Project Periods 

 

  • Goal - 2%  reduction for the hospitalization, 30-day unplanned readmissions and ER visits –Project period runs June 1, 2021 - April 1, 2022 
  • Goal - 5% reduction for patients hospitalized due to COVID-19 - Project period runs March 1, 2021 – November 30, 2021

 

Facility Resources and Strategies

Patient Resources

Presentations