From 'Hospital to Home'—to stay

IRVING, Texas - Greg Spratt, the new homecare chair for the American Association for Respiratory Care (AARC), thinks respiratory therapists (RTs) can play a major role in reducing hospital readmissions for respiratory patients.

That's why he's developing a program called "Hospital to Home," to educate therapists--both home- and hospital-based--on how to work together to do just that.

"In most situations today, there really is very little communication going on between the two sides," said Spratt. "I think both sides are focused on patient care, but oftentimes, when a patient is discharged, it's simply about getting them home as quickly and efficiently as we can."

That can lead to patients bouncing back to the hospital, because they don't understand what they need to do in order to stay well.

"The environment of a hospital is very well-controlled," said Spratt. "Patients are in bed and I tell them what to do and they do it. It's very different from the home."

Thanks to a provision in the health care reform law, hospitals with high readmission rates for patients with congestive heart failure and pneumonia will face financial penalties. Respiratory providers that can show outcomes that reduce those rates will find themselves with some new opportunities, said Spratt.

"Hospitals are going to be looking for that," he said.

Ensuring that RTs on both sides understand each other's patient care challenges will be an important part of reducing those rates, said Spratt.

"The education is going to have to fall on both sides," he said. "Certainly, it needs to start in the hospital before discharge and then be supported on the homecare side."

Spratt is in the process of developing a member survey to identify the five or 10 key principles for preventing hospital readmissions. For example, making sure patients eat enough or remember to take their medications.

"Those are very simple things, but those are the things that put people back in the hospital," said Spratt. "We want to identify those problems and then look at what the best solutions are."

Once those principles are identified, Spratt will concentrate on developing educational tools for clinicians and patients. Those tools could take the form of webcasts to educate therapists, and a brochure or booklet that could be used by patients and therapists.