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Shawnee Mission Medical Center

Project RED Success Story

Shawnee Mission Medical Center (SMMC) reduced its average overall readmission rate in 2011 from 32.4% for non-transition coach assisted patients to 12.2% for transition coach assisted patients.

Since that time, the rate has continued to drop, falling below 9% for the first quarter of 2012.

SMMC knew early in the project that follow-up phone calls from a discharge advocate would not be an effective way to reach its patients, who tend to live in poorest sections of Kansas City and do not have reliable phone access.

With support from senior management, SMMC initiated home visits and began working at engaging external groups in applying Project RED. They formed a transitions of care work group with external providers to look at care coordination and resolve transition of care problems.

Kim Fuller, MSW, Director of Quality, reports that SMMC recognized a need to help people in the late stages of their illness and developed a palliative care program for these patients. Overall, Project RED exceeded expectations. According to Fuller “We expected the readmission rate, particularly for CHF, to decrease, and over time that rate has decreased significantly."