A database plan for nursing practice requires specific knowledge of nursing units, the work that is performed, the records that are kept, how information flows throughout the organization, and how patients are triaged from one area to the next. These elements are critical to the success of the database effort and its implications for success in improving data management and quality of care for all patients. However, many organizations face critical problems in their efforts to achieve the proper flow of data from one department to the next to achieve maximum efficiency in all areas, while at the same time providing the highest possible quality of care to all patients. Therefore, an effective database strategy must be developed that will accommodate these needs and will also provide additional insight into the flow of information throughout the organization to reduce readmissions to the emergency department.
Readmissions to the emergency department are a common phenomenon, yet they are highly cost prohibitive because they take away valuable services and resources from other patients (Miller, 2012). As a result, it is likely that the ability to save money over the long term must include a reduction of patient readmissions to the ED (Miller, 2012). It is important to identify where weaknesses prevail and the flow of information is limited in order to capture a greater understanding of the system (Miller, 2012). At the same time, an effective database portal must be established that will work to correct prior errors and to minimize future errors to prevent readmissions as best as possible.
One area to consider with the database plan is care coordination, whereby a group of healthcare professionals work cooperatively in order to provide patients with education at admission and discharge, high quality treatment, and follow-up care in the home or other environment (The City of New York, 2013). Therefore, the coordination of care must be reflected in the database plan so that the flow of information is properly tracked and is readily accessible to all caregivers throughout the process (The City of New York, 2013). This reduces the financial culpability of those involved in care and treatment at all phases and is likely to provide patients with a reduced risk of readmission to the ED (The City of New York, 2013).
In order to reduce readmission rates, it is necessary to identify areas where quality of care has been less than effective or has been compromised because these elements play an important role in determining how to reduce readmission rates (Robert Wood Johnson Foundation, 2013). In essence, there is a “need for better communication between providers and patients, and also between hospital staff and patients’ personal physicians” (Robert Wood Johnson Foundation, 2013). This will facilitate the improved flow of information from one area to the next and will work to accomplish greater accuracy regarding important information that will lead to positive outcomes for patients (Robert Wood Johnson Foundation, 2013). Therefore, the database plan must demonstrate that the organization is taking readmission rates seriously and that there is direct communication regarding patients from the emergency department through all areas where the patient is seen, from admissions to the specialty unit to discharge and then through follow up (Robert Wood Johnson Foundation, 2013). If this is not the case, then the organization faces critical challenges in its communication efforts and its ability to deliver information seamlessly from one department to the next (Robert Wood Johnson Foundation, 2013).
Based upon these conclusions, the development of a successful database framework for a healthcare organization to reduce ED readmissions must reflect all information that is observed regarding a patient, which is then recorded in a location that is easily accessible by other clinical staff. This practice will enable staff members to recognize the elements of direct care that are required for a patient and how this impacts their recovery. In addition, it will reduce the potential risk of readmission for the same condition at any point in the future that is a result of poor quality of care and limited follow through.
The City of New York (2013). Care coordination yields lower readmission rates. Retrieved from http://www.nyc.gov/html/hhc/html/newsletter/201209-lower-readmission-rates.shtml
Miller, 2012, H. Reducing readmissions: a comprehensive approach to reducing costs and improving quality. Retrieved from http://www.avoidreadmissions.com/wwwroot/userfiles/documents/89/haroldmiller-readmissions-01-04-12-5.pdf
Robert Wood Johnson Foundation (2013). Readmission rates only tell part of the story. Retrieved from http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2013/01/readmission-rates-tell-only-part-of-the-story.html