Date of Conferral

8-8-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Miriam Ross

Abstract

Non-profit healthcare administrators in United States hospitals face the challenge of hospital readmissions, especially due to the CMS Hospital Readmission Reduction Program (HRRP), which affects reimbursement. The purpose and review question for this integrative review was to research evidence-based strategies that could be implemented to improve the discharge planning process in non-profit hospitals and reduce readmissions for patients with HRRP diagnoses. A review of literature identified 126 articles for analysis, with 25 studies selected for quality assessment using the Johns Hopkins Nursing Evidence-Based Practice Model and the Research Evidence Appraisal form. The Donabedian framework provided a structured approach for evaluating the effectiveness and efficiency of healthcare delivery services. Five major themes were used to determine the recommendations: assessing patients' living conditions, enhancing discharge education, shared decision-making, fortifying the hospital staff team, and developing a care-continuation plan. Additionally, nine subthemes strengthened the main themes: addressing patient risks for HRRP readmissions, identifying patient support systems and economic needs, strengthening health information, applying teach-back techniques, establishing appropriate goals, encouraging patient and family input, care team collaboration, post-discharge follow-up, and remote medication monitoring. Recommendations for enhancing discharge planning and promoting positive social change include fostering collaboration between physicians and staff, promoting patient and family engagement, forming multidisciplinary teams, and advancing patient education.

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