Reducing All-Cause Hospital Readmissions

Patient discharges from the inpatient acute care settings may involve transition to home or to another health care facility such as a rehab or skilled nursing facility. Improving these transitions may result in the reduction of patients that need to be readmitted to the hospital. As hospitals and health care facilities focus on quality and patient experience, reducing readmissions has become a top priority.

When a patient discharged from a hospital is readmitted within 30 days, it is known as a hospital readmission. Many times hospital readmissions can be avoided.

Sharing best practices to reduce hospital readmissions.

Readmissions may occur as the result of:

  • Premature discharge
  • Poor communication during the discharge process, including transfers to another facility
  • Less than optimal care coordination before and after discharge
  • Challenges caring for a patient with complex medical needs at home or in other care settings
  • Patient social determinants of health such as access to transportation, medications, and a support system

HAP is working with Pennsylvania hospitals to improve patient care transitions and reduce readmissions by:

  • Supporting hospitals to focus on reducing readmission rates as a top priority
  • Providing services that share best practices to improve processes and policies surrounding readmissions
  • Developing tools for hospitals to reduce readmissions rates
  • lncreasing patient and family engagement
  • Connecting hospitals, post-acute providers, and patients with community organizations

HAP Contacts

For additional information about participating in the Readmissions Reduction Project, or if you have a best practice to share, please contact Beth Murray, project manager. Media inquiries should be directed to Kim Yakowski, manager, media relations.

 


HAP News


November 10, 2025

Remote Blood Pressure Monitoring Improves Outcomes for New Mothers

Ensuring the safety of new mothers and the healthy outcome of their pregnancies doesn’t stop at the hospital doorstep. One of the biggest post-delivery complications for mothers is hypertension. To address this potentially fatal health risk, experts at Main Line Health have created a remote blood pressure monitoring program to support mothers at home following delivery.

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