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Reducing the Rate of Rehospitalization from Postacute Care: A Quality Improvement Project

Jacelon, Cynthia PhD, RN-BC, CRRN, FAAN1,2; Macdonald, Barbara MS, RN, GCNS-BC3; Fitzgerald, Fran RN4 Quality Council

Rehabilitation Nursing Journal: January 2015 - Volume 40 - Issue 1 - p 12–19
doi: 10.1002/rnj.176
Continuing Education

Purpose: To evaluate rehospitalizations and develop a strategy to reduce the number of individuals sent back to the hospital within 30 days of admission from postacute care services including skilled care, long-term care, and home care.

Design: Using the Plan, Do, Study, Act (PDSA) format outlined by the Institute for Healthcare Improvement, we implemented and evaluated a quality improvement project.

Methods: The number of rehospitalizations was calculated and chart audit was used to determine the reasons. Interventions were designed to decrease the number of reasons individuals had to return to the hospital.

Findings: Five rehospitalizations were deemed preventable. Interventions were designed to improve staff knowledge.

Conclusions: The effectiveness of interventions and rehospitalization rates continue to be monitored. The rehospitalization rates from these agencies are low. Low rehospitalization rates are good for clients and improve desirability as a source for care posthospitalization.

Clinical Relevance: Understanding causes for rehospitalization, providing skills and knowledge aimed at the root causes of hospitalization, and reducing the rate of rehospitalization improves nursing practice and reimbursement.

1College of Nursing, University of Massachusetts, Amherst, MA, USA

2Jewish Geriatric Services, Longmeadow, MA, USA

3Julian J. Leavitt Jewish Nursing Home, Longmeadow, MA, USA

4Spectrum Home Health & Hospice Care, Longmeadow, MA, USA

Accepted 4 June 2014


Cynthia Jacelon, College of Nursing, University of Massachusetts, 126 Skinner Hall, 651 N. Pleasant St. Amherst, MA 01003. E-mail:

Grant sponsor: Scholar in Residence Grant; Grant sponsor: Jewish Geriatric Services.

© 2015 Association of Rehabilitation Nurses.
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