“Hospital to Home” Survey Results are In

September 16, 2011

Earlier this year the AARC Management and Home Care Sections began work on a new program aimed at easing the transition between hospital and home for chronic lung disease patients. The first step was to conduct a survey of the nation’s RT departments to get a feel for the kinds of services hospitals are offering in this area today, and what they anticipate for the future as the federal government’s Hospital Readmissions Reduction Program goes into effect.

Now the results are in. Here are just a few of the key take home messages for hospital-based and home care RTs alike; the full report is available to Management and Home Care Section members on AARConnect—

While 35.8% of respondents did report they are doing nothing to address COPD hospital readmissions at this point, many RT departments are already in the process of tackling the problem:

• 41.5% are using evidence-based algorithms, pathways, guidelines, or protocols.
• 20.2% are creating COPD programs that addresses inpatient, discharge, and outpatient needs.
• 11.9% are partnering with local DME companies to create programs that enhance patient care in the home.
• 9.8% are providing follow up phone calls to patients after discharge.
• 8.8% are creating disease specific nursing floors for patients with cardiopulmonary disease.
• 5.7% are using RTs as case managers/discharge planners.
• 2.6% have created a COPD coordinator position.

When asked about factors that contribute to the readmission of the cardiopulmonary patient, 68.9% of respondents cited non-compliance with prescribed medications as being extremely relevant. Other factors deemed extremely relevant by respondents include:

• Refusal to discontinue smoking (55.2%).
• Inadequate knowledge of how to use therapy devices (50.5%).
• Inadequate knowledge of medications (45.0%).
• Inability to provide self-care (41.5%).
• Non-compliance with home oxygen (41.1%).
• Lack of support system in the home (40.4%).
• Lack of follow-up with physician (37.0%).
• Developing an infection following discharge (30.9%).

When asked to rank various factors that stand in the way of cooperative communication between hospital-based and home care RTs on a scale from one to five, with one being the most important, respondents gave the following factors a number one:

• Lack of a defined pathway for cooperative management (37.8%).
• Time constraints of the hospital RT (29.0%).
• Lack of definition in responsibilities (22.8%).

Stay tuned to your AARC publications for updates as the Management and Home Care Sections continue their efforts to identify new and better ways for all of us to work together to improve the transition from hospital to home for our chronic lung disease patients. In the meantime, if you’d like more information on this survey, get involved with the Management or Home Care Sections.