Your Resource for HQIC Highlights and Learning Opportunities | Jan. 2022
Reducing 30-Day Hospital Readmissions for Patients With COVID-19
A recent study in the November 2021 issue of The Joint Commission Journal on Quality and Safety examined the preventability of 30-day hospital readmissions for patients admitted to the hospital with COVID-19. Findings showed 13 percent of COVID-19 hospitalizations resulted in a 30-day readmission. Of these, 26 percent were potentially preventable.1

The most frequently cited intervention for avoiding preventable readmissions was an improved self-management plan at discharge. “Self-management planning involves educating patients and caregivers about medication changes, follow-up appointments, and symptom management. Moreover, it involves shared decision-making about whether the self-management plan is feasible, or whether functional or cognitive limitations necessitate additional home services or discharge to a skilled nursing facility.”2 Additionally, video conferencing between the patient, caregivers, and the healthcare team can be a valuable tool to provide education regarding the discharge plan.

The study concluded that although approximately one-quarter of 30-day readmissions for patients with COVID-19 were potentially preventable, these results highlight opportunities to reduce readmissions in the future, both in pandemic conditions and beyond.
It Figures—Data and Performance
The data show that there has not been improvement in all-cause readmission rates since the baseline period of 2019. However, if COVID-19 readmissions are excluded, some improvement is noted (lower is better).

Visit the HSAG HQIC Quality Improvement Innovation Portal (QIIP) to view your readmission data by selecting the “Measure Category” of “Readmit-Mortality” and “Measures of Readmissions: All-Cause and Readmissions: All-Cause (COVID Excluded).”
The Flash: Resources
Hospital Readmissions Roadmap to Success 
This roadmap assists hospital teams in developing a readmission reduction plan. The roadmap helps teams determine the causes of readmissions and gaps in care. This information can help improve care transition practices, delivery of care, and discharge/post-discharge communication and follow up.
Social Work Assessment
Use this form to document and assess a patient's post-discharge support network and needs so a custom care plan can be developed.
COVID-19 Zone Tool
This patient tool includes self-management checklists for COVID-19 discharged patients to assess themselves based on green (in control), yellow (caution, your doctor), and red (seek immediate medical attention) zones.
Home Health Services Video
This short video encourages patients to accept home health services and learn what to expect from home health visits. Show this to patients getting ready for hospital discharge.
Critical Communication
Are You Prepared? A CDC COVID-19 Checklist
This Centers for Disease Control and Prevention (CDC) document, Comprehensive Hospital Preparedness Checklist for Coronavirus Disease 2019 (COVID-19), is designed to assist with preparedness planning to ensure staff are trained, equipped, and capable of: preventing COVID-19 spread within the facility, promptly identifying and isolating positive patients, caring for patients with COVID-19, monitoring and managing healthcare personnel exposures, and communicating COVID-19-related information.
Events and Education
HSAG HQIC Quality and Safety Series
The Quality and Safety Series is designed to assist your organization in its quality improvement (QI) journey, from planning and preparation to sustaining gains.

The series, scheduled through July 2022, takes place the 2nd and 4th Tuesdays of the month. These 30-minute-or-less "quickinars" are bite-size learning presentations that review the key skills necessary for you to function in the QI role or for other staff members who are participating in a QI initiative. The quickinars are intended as a foundation for the novice or as a skills refresher for the expert. Recordings from past presentations are available at:
Quality and Safety Series 11: Reliable Processes
Tuesday, January 11, 2022, 2–2:30 p.m. ET
Quality and Safety Series 12: Five Whys
Tuesday, January 25, 2022, 2–2:30 p.m. ET
Spreading Communication and Optimal Resolution (CANDOR) Across an Enterprise
Tuesday, January 18, 2022, 12 noon–1 p.m. ET
CANDOR is a process that healthcare institutions and practitioners can use to respond in a timely, thorough, and just manner when unexpected events cause patient harm. This webinar will share how CommonSpirit Health has implemented and spread CANDOR throughout its health system.

  • Identify the process, components, and benefits of CANDOR.
  • Examine how to successfully implement and sustain the CANDOR process.
  • Discuss how to engage staff, patients, and families in the planning, implementation, and evaluation of the CANDOR process.

Austin Peterson, RN, BSN, MBA-HCM
Winifred Stump, BSN, RN, MS, CPPS, CHSP
Continuing Education (CE): Health Services Advisory Group, Inc., is the CE provider for this event. Provider approved by the California Board of Registered Nursing, Provider Number 16578, for 1 contact hour. There is no charge to attend this event. You must attend the live event to earn CE credit.
HSAG Opioid Stewardship Program
Join HSAG in an action-based quickinar series to provide tactics, strategies, and information needed to implement a successful opioid stewardship program.

The 11 opioid stewardship quickinars are short, 30-minute webinar presentations that began on October 21 and run through May 2022. Recordings from past presentations are available when you click the registration button.
Screening Patients for Opioid Use Disorder Risk and Opioid Withdrawal
Thursday, January 13, 2022, 1:30–2 p.m. ET
A Good Discharge Plan for Pain Management with Opioids
Thursday, January 27, 2022, 1:30–2 p.m. ET
HSAG Care Coordination Series
Join HSAG in an action-based quickinar series to provide tactics, strategies, and information needed for managing avoidable hospital readmissions.

The 11 quickinars are short, 30-minute webinar presentations that begin in January and run through August 2022. They are offered on the first and third Tuesdays of the month.
1. Care Coordination During a Pandemic
Tuesday, January 18, 2:00–2:30 p.m. ET
1, 2. The Joint Commission Journal on Quality and Safety.
This material was prepared by Health Services Advisory Group (HSAG), a Hospital Quality Improvement Contractor (HQIC) under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication No XS-HQIC-XT-12212021-01