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Winnebago Mental Health Institute Readmission Rate Project

Project workgroup Change Leaders: Kim Lewis, Kim Packee, Carol Thomas Members: Phil Sweet, MD; Shanna Her, SW; Jen Johnson, RN; Miah Olson, SAC; Tina Klemmer, Admissions/Registrar; Erin Sarauer, Civil Services Director; Beverly Pezewski, HIM Director; Bonnie Purtell, QM Director

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Winnebago Mental Health Institute Readmission Rate Project

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  1. Project workgroup • Change Leaders: Kim Lewis, Kim Packee, Carol Thomas • Members: Phil Sweet, MD; Shanna Her, SW; Jen Johnson, RN; Miah Olson, SAC; Tina Klemmer, Admissions/Registrar; Erin Sarauer, Civil Services Director; Beverly Pezewski, HIM Director; Bonnie Purtell, QM Director • Executive Sponsor: Tom Speech Ph.D. Winnebago Mental Health Institute Readmission Rate Project

  2. “Reduce the percentage of civil patients who are discharged and re-admitted to a state institution within 30 days, through implementing a quality improvement process that continuously identifies the causes and solutions to re-admissions” 2012 National State Hospital Average # of Readmissions = 7.4% 2008 WMHI Avg= 7.6% 2009 WMHI Avg= 8.9% 2010 WMHI Avg= 7.8% 2011 WMHI Avg= 9.5% 2012 WMHI Avg= 7.1% Department of Health Services (DHS) Goal

  3. 7.4% Readmission Rate (October 2011-September 2012 Readmission Analysis Data) • 1506 Total Civil admissions ( 16% FY) • 111 readmissions • 44% Youth/56% Adult • 40% Male/60% Female • 58%Mood Disorders/18%Psychotic Disorders/9% DD • Top 2 Reasons for Readmission • 1) Aggression • 2) Suicidality • Readmission Analysis: Implemented on all civil patients discharged and readmitted within 30 days Who Is Being Readmitted and Why?

  4. Our Process • Our Admission Coordinators screen each civil patient that is admitted • The Admission Coordinator notifies the SW that this is a readmission. • The SW completes the Readmission Analysis immediately. • The SW, in collaboration with the patient and the county, completes the Crisis Plan prior to discharge. • Copies of the Crisis Plan will go with the patient and the county upon discharge. A Crisis Plan would be completed on all civil patients that were discharged and re-admitted within 30 days. THE CHANGEADOPT. . .

  5. Continue to work with patients and county staff to develop crisis plans together. • Gather data/determine if Crisis Plans are effective • If Crisis Plans prove effective --Determine ways to expand their use Next Steps

  6. And along the way . . . Learn from the Readmission Analysis Data/Crisis Plan to identify . . . • Populations at risk • Most effective aftercare resources • Specific treatment to address crisis issues. Long-term Impact: Reduce 30 day readmission rate to WMHI

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