• Innovation in Action

Oct 10, 2023

Hospital Addresses High Readmission Rate Among Black Population Using Pre- and Post-Op Education


When the 2023 Joint Commission health equity standards were released, Crossroads Community Hospital in Illinois examined their key strategic outcomes and dashboard metrics looking for variations by age, gender, and race/ethnicity. Through their analysis using the Premier QualityAdvisor benchmarking tool, they saw that Black patients had a 53% higher than expected readmission rate index compared to the rest of the population.

Further examination discovered there was a population of Black men who would have surgery and then return with small bowel obstruction at a rate significantly higher than other populations. The team learned that these patients, who were coming in for a specific type of surgery, were not receiving education about post-discharge bowel and bladder routines.

Crossroads documented this disparity to discuss with both the Medical Executive Committee and Senior Executive Committee that consisted of pharmacy, surgery, nursing, informatics, and other staff members.

The team worked with the department of medicine to create a post-op bowel routine and provide a prescription for Colace medication to patients. Surgeons then began educating their patients during pre-op and post-op and ensured that they received a prescription for medication.

They provided bowel routine education and taught patients what medications, foods and drinks they should use and avoid after surgery. Since the launch of this education program, Crossroads Community has had no patients without a known history of bowel obstruction be readmitted for this issue.

Michelle Darnell, Director of Quality at Crossroads, said her participation in Health Equity Now (HEN) workgroup sessions provided access to resources and diagrams which reinforced that her team was on the right track. She also said that networking was also very helpful during the Huddle sessions.

Looking ahead, Crossroads aims to focus on reducing disparities in readmissions rates for patients aged 65-79 from 12% to 8.2% (which is the normative value). They want to understand root causes of this disparity to build out programming that could focus on chronic disease care management and address social drivers of health.

For organizations engaging in health equity work, Michelle recommends “going through the process of narrowing the scope of what is manageable so that you can find information and make more meaningful change,” she said. “You can make improvements by focusing on one population at a time. It takes a lot of discipline to figure out what is an actionable level of data. Get more granular at the population [level] to figure out how to address the specific issue. You can still reach the goals in the end.”

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