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HQIC Community of Practice Call | Readmissions: Multiple-Admission Patients

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Patients who are frequently admitted to hospitals are likely to have multiple complex chronic conditions. These frequent hospital admissions may be considered an indicator –– or “red flag” –– of a patient’s physical, mental, spiritual and social deprivation in their daily lives.  Eastern US Quality Improvement Collaborative (EQIC) has developed the Multiple-admission Patient Program which provides best practices to identify patients who are frequently admitted to the hospital and address contributing factors for admission or readmission. EQIC’s four-step framework helps hospitals design a MAP program, identify patients that meet MAP criteria, assess risk factors upon admission and customize individual interventions aimed at decreasing admission or readmission. EQIC uses a collaborative approach by including care partners and community-based organizations to address behavioral, social and clinical needs of patients.  During this recorded webinar, we discussed the importance of identifying and managing readmissions efforts to consistently encourage hospitals to analyze their data to identify patients with multiple admissions, specifically those who have been admitted to the hospital four or more times in a 12-month period.

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Centers for Medicare & Medicaid Services


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