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Check out our study in @BMJ_Qual_Saf:Differences in transitional care processes among high-performing & low-performing hospital-SNF pairs using a rapid ethnographic approach
@BBurkeMD @RomeAyele @EGalenbeck @vaequity @NCSP_Penn @SeaDenCOIN @PennNCTH https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204
2/Hospital readmission from skilled nursing facilities (SNFs) are 
, yet best practices for 
are unclear. So we used a rapid ethnographic approach to understand how hospitals prepare patients for SNFs & explore diffs btwn hospital-SNF pairs w high/low 30-day readmission rates.
, yet best practices for are unclear. So we used a rapid ethnographic approach to understand how hospitals prepare patients for SNFs & explore diffs btwn hospital-SNF pairs w high/low 30-day readmission rates.
3/Using a rapid ethnographic approach we identified 5 major processes for preparing patients to be discharged for post-acute care:
Recognizing need
Deciding level of care
Selecting provider
Negotiating patient fit
Coordinating care
https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204 @BMJ_Qual_Saf
Recognizing needDeciding level of careSelecting providerNegotiating patient fitCoordinating carehttps://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204 @BMJ_Qual_Saf
4/One of the neat ways we identify the process used by hospitals to prepare patients for discharge to SNFs was through process mapping! This approach allowed us to identify common themes of the process & differences btwn performance types.
https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204
@qualityscholar
https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204
@qualityscholar
5/ During each stage, we found that high-performing sites differed from low by focusing on:
Earlier, ongoing, systematic identification of high-risk
patients
Discussing the PAC decisions as a team-based
iterative process
Anticipating barriers with knowledge of SNF needs
Earlier, ongoing, systematic identification of high-riskpatients
Discussing the PAC decisions as a team-basediterative process
Anticipating barriers with knowledge of SNF needs
6/Last, we linked each process for preparing patients for SNF to target points & interventions based. One area I found surprising was that high performers emphasized the importance of early identification and matching care to goals.
https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204
https://qualitysafety.bmj.com/content/early/2020/09/20/bmjqs-2020-011204
