Quality collaboratives and campaigns to reduce readmissions: what strategies are hospitals using?

J Hosp Med. 2013 Nov;8(11):601-8. doi: 10.1002/jhm.2076. Epub 2013 Sep 6.


Background: Reducing hospital readmissions is a national priority, and many hospitals are participating in quality collaboratives or campaigns.

Objective: To describe and compare the current use of hospital strategies to reduce readmissions in 2 prominent quality initiatives-STAAR (State Action on Avoidable Rehospitalization) and H2H (Hospital-to-Home Campaign).

Design: Cross-sectional.

Methods: Web-based survey of hospitals that had enrolled in H2H or STAAR from May 2009 through June 2010, conducted from November 1, 2010 through June 30, 2011 (n = 599, response rate of 91%). We used standard frequency analysis and multivariable logistic regression to describe differences between STAAR and H2H hospitals.

Results: Many hospitals were not implementing several of the recommended strategies. Although STAAR hospitals tended to be more likely to implement several strategies, differences were attenuated when we adjusted for region and ownership type. In multivariable models, STAAR hospitals compared with H2H hospitals were more likely to ensure outpatient physicians were alerted within 48 hours of patient discharge (63% vs 38%, P < 0.001), and more likely to provide skilled nursing facilities the direct contact number of the inpatient treating physician for patients transferred (53% vs 34%, P = 0.001). H2H hospitals were more likely to assign responsibility for medication reconciliation to nurses usually or always (80% vs 54%, P = 0.001) and more likely to give most or all discharged patients referrals to cardiac rehabilitation services (59% vs 41%, P = 0.001).

Conclusions: Substantial opportunity for improvement exists for hospitals engaged in STAAR or H2H quality initiatives.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Continuity of Patient Care / organization & administration*
  • Continuity of Patient Care / standards
  • Cooperative Behavior
  • Cross-Sectional Studies
  • Health Care Surveys
  • Health Plan Implementation / statistics & numerical data
  • Humans
  • Information Dissemination / methods
  • Internet
  • Logistic Models
  • Medication Reconciliation / methods
  • Medication Reconciliation / organization & administration*
  • Multivariate Analysis
  • Patient Discharge / standards*
  • Patient Discharge / statistics & numerical data
  • Patient Readmission / standards*
  • Patient Readmission / statistics & numerical data
  • Quality Assurance, Health Care / methods
  • Quality Assurance, Health Care / organization & administration*
  • Quality Indicators, Health Care
  • United States