In early 2021, Dr. Brian Parker knew his health system was in trouble. As chief quality and learning officer at Allegheny Health Network, he and the executive team made the call in 2020 to pause several discharge-related quality improvement projects. Patient volumes had declined dramatically because of a statewide order suspending all elective procedures and surgeries.
By late 2020, elective surgeries had resumed, the hospital system was swamped by COVID-19 patients. Admitting and discharging patients as quickly as possible loomed as a threat to quality and safety. That led the Pittsburgh-based not-for-profit system to renew its readmissions prevention work.
“Once we saw what was coming—what we thought was that light at the end of the tunnel but it was a train, it was delta (variant)—that’s when we really made the determination that discharge work needed to be reinvigorated again, because we were going to have gridlock,” Parker said.
The 14-hospital system separated COVID-19 patients from the others. As the executive responsible for tracking metrics such as readmissions, Parker played a vital role in ensuring patients in hospitals for reasons other than the novel coronavirus could get appropriate, safe care.
Discharge work has always been important, because patients are flooded with information hours before going home. Once they’re on their own, how well a patient follows those directions can make or break recovery.
“Each time a patient has another (chronic obstructive pulmonary disease) or congestive heart failure exacerbation, it reduces their lung or heart function,” and that in turn creates a sicker patient who is harder to treat, said Dr. David Burwell, chief quality officer for UPMC facilities in central Pennsylvania and western Maryland. “Making sure that they continue to be successful (at home) is really important.”