Involving family members in discharge planning cuts hospital readmission rates: study

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Juleen Rodakowski, OTD, MS, OTR/L
Juleen Rodakowski, OTD, MS, OTR/L

Systematically integrating informal caregivers into the discharge planning process for older adults reduces hospital readmissions by 25%, according to an analysis published this month by the Journal of the American Geriatrics Society.

The study did not include older adults who reside in senior living settings and, therefore, researchers can't say for certain whether family caregivers could help reduce readmission rates for senior living residents, lead author Juleen Rodakowski, O.T.D., M.S., O.T.R./L., told McKnight's Senior Living.

“My hope, however, is that there are principles about including caregivers in all transitions that could support resident health and wellbeing,” said the assistant professor in the University of Pittsburgh's School of Health and Rehabilitation Sciences.

Family caregivers are assuming considerable care responsibilities for older adults, Rodakowski said. “This includes increasingly complex treatment, such as wound care, managing medications and operating specialized medical equipment,” she said. “With proper training and support, caregivers are more likely to be able to fulfill these responsibilities and keep their loved ones from having to return to the hospital.”

The researchers systematically reviewed 10,715 scientific publications related to hospital patient discharge planning and older adults. Integrating family caregivers into discharge planning, they found, resulted in a 25% reduction in risk of the elderly patient being readmitted to the hospital within 90 days, and a 24% reduction in risk of their being readmitted within 180 days, when compared with control groups where no such integration occurred.

“While integrating informal caregivers into the patient discharge process may require additional efforts to identify and educate a patient's family member, it is likely to pay dividends through improved patient outcomes and helping providers avoid economic penalties for patient readmissions,” said senior author A. Everette James, J.D., M.B.A., director of Pitt's Health Policy Institute and its Stern Center for Evidence-Based Policy.

The study finding validates the Caregiver Advise, Record and Enable Act, which has been adopted by more than 30 states and the District of Columbia, and proposed Medicare regulations that require caregiver identification and training before patients leave a health facility, the researchers said.

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