1:45-2:45 pm
Room: 229 AB North

Identifying the Root Causes of Readmission
Presenters: Patricia Alberto, MPH BSN RN CPHQ, and Brian P. Zunner-Keating, MS RN CPHQ PHNA-BC

In this session, you will compare and contrast single reviewer and interdisciplinary team case reviews to determine the root causes of unplanned 7-day all-cause readmissions. Readmissions are common; often targeted for quality improvement and cost reduction. While volume trends are recognizable, identifying root causes provide deeper insight towards tangible, achievable reduction goals. We will demonstrate application of different methods to identify root causes and subsequently prioritize interventions for the benefits and drawbacks of these two methodologies and help you identify the best approach for your institution. By creating novel, discrete code lists and decision trees, you can identify specific root cause trends. Additionally, we will describe how to navigate common obstacles to ensure inter-rater reliability, distinguish "preventable" from "unpreventable" readmissions, and garner physician engagement.

Learning Objectives:

  • Identify and apply five common institution-level root causes for unplanned 7-day hospital readmissions as a part of your institutional planning process
  • Identify the benefits and drawbacks of the two root cause review methodologies discussed
  • Determine which root cause review methodology is the best approach for your institution
  • Describe one way to improve inter-rater reliability in describing and classifying root causes

Patricia Alberto is an experienced registered nurse with clinical expertise in pediatric hematology-oncology. With a commitment to improve quality outcomes, patient care service and delivery, Mrs. Alberto expanded her clinical nursing expertise to hospital administration at UCLA Health as a Quality Specialist. In this role, she facilitated departmental physician and nursing peer reviews and root cause analyses to identify opportunities for improvement and potential sustainable solutions. Currently, Mrs. Alberto serves as a Lean Specialist with Performance Excellence at UCLA Health where she facilitates the development and execution of continuous system-wide performance and process improvement projects including readmission reduction, discharge planning and throughput initiatives that align with institutional strategic objectives. Mrs. Alberto received her bachelor's degree in nursing with a minor in public health and her master's degree in public health major with an emphasis on healthcare management from the University of California, Los Angeles.

Brian Zunner-Keating is a registered nurse with clinical expertise in public and community health. With 10 years of experience, Zunner-Keating has worked with home health, inpatient respite care for the homeless, and a pediatric mobile medical program for low-income families. As a Lean Specialist with Performance Excellence at UCLA Health, he currently develops, facilitates, and executes system-wide quality improvement efforts focused on improving clinical outcomes, the patient experience, and reducing cost to support quality, capacity, growth objectives, and sustainable performance. Zunner-Keating is nationally certified as an Advanced Public Health Nurse and a Certified Professional in Healthcare Quality® (CPHQ). His published work focuses on bias in healthcare and unmet mental health needs. Zunner-Keating received his bachelor's degree in nursing from Boston College and his master's degree in advanced practice public health nursing from the University of California, San Francisco.

Audience Level: CPHQ/Mid
Topic: Performance & Process Improvement
Date: September 16