MedicalResearch.com Interview with:
Thomas P. Meehan, MD, MPH
Associate Medical Director
Harvard Pilgrim Health Care
Quinnipiac University, North Haven
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is a national effort to decrease preventable hospital readmissions in order to improve both the quality and cost of healthcare. Part of this national effort includes local quality improvement projects which are organized and conducted by a variety of organizations working by themselves or with others. We describe one statewide quality improvement project which was led by a Medicare-funded Quality Improvement Organization and conducted with a hospital association and many other collaborators. We document our activities and a relative decrease in the statewide 30-day aggregate readmission rate among fee-for service Medicare beneficiaries of 20.3% over four and a half years. While we are extremely proud of our work and this outcome, we recognize that there are many factors that impacted the outcome and that we can’t claim sole credit.
MedicalResearch.com: What should readers take away from your report?
Response: We intended to provide real world detail on what happens in a statewide, voluntary-participation quality improvement collaboration. These types of projects are very different from research collaboratives which have strict protocols and mandatory implementation, and thus, are very challenging to evaluate. Our lessons learned are mainly practical insights about working together to achieve concurrent institutional, community-level, and statewide improvements in care.
Some of what we learned is that:
1) there is a growing science to community-based healthcare quality improvement, and multi-disciplinary, multi-organization collaborations can function well if properly structured and facilitated;
2) large group and organization-specific training and technical assistance are complementary approaches to quality improvement; and
3) real barriers to success are ubiquitous but approaches to addressing these barriers are also available.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: In addition to traditional research studies with experimental study designs, I would like to encourage others that are working to improve the quality of health care “in the field” to write up your projects and submit them for publication. I believe that there is as much to learn from quasi-experimental and observational studies as there is from traditional research, especially with regard to practical insights on how things really work.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Thomas P. Meehan, Sr, Anne Elwell, Thomas P. Meehan, Jr, Shih-Yieh Ho,Thomas J. Van Hoof, Dan Ray, Casey Thomas, Alison Hong, Wendy Martinson,and Terri Savino
Description and Impact Evaluation of a Statewide Collaboration to Reduce Preventable Hospital Readmissions
American Journal of Medical Quality 1062860616659356, first published onJuly 13, 2016 as doi:10.1177/1062860616659356
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