Hospital readmission reduction at Mercy Health System
Telehealth, home health aides and more from Mercy Home Health.
Mercy Home Health is unique in that the team starts working as soon as a patient is admitted to the hospital, says Ruth Martynowicz, vice president of operations at Mercy Home Health. “Right from the time a patient enters the hospital, we are already working to provide them with a safe transition back home,” she explains. “We meet with patients and their hospital healthcare providers, collaborating on care coordination across the continuum. That is a service that goes above and beyond what other home cares in the area offer.”
The ultimate goal of Mercy Home Health is preventing unnecessary readmissions to the hospital. “We are reducing the number of hospital readmissions every month,” says Ruth.
Home Health clinicians evaluate each patient’s medical needs focused on two simple questions: Does the patient live alone? Would additional clinical support help avoid hospital readmission? For those who need it, Mercy Home Health installs Telehealth equipment in the home, where information such as heart rate, weight, blood pressure and oxygen levels is sent wirelessly every day to Mercy Home Health registered nurses who monitor for adverse readings.
Mercy Home Health’s established relationships with outpatient nursing and rehabilitation facilities ensure that all healthcare professionals caring for the patient, regardless of location, are knowledgeable of the patient’s status and the plan of care.
“When a patient is discharged from a skilled nursing facility or rehab and their health declines, Mercy Home Health clinicians along with the patient’s physician discuss the next steps,” says Ruth. “Most often, instead of the patient being readmitted to the hospital, we intervene to see if they should go back to skilled nursing or if the issue can be resolved through comprehensive home care. It’s a lower-cost alternative and lowers the risk for the patient.”