Mercy Medical Center in Cedar Rapids, Iowa, had readmission rates in the lowest 3 percent among U.S. hospitals in all three clinical areas—heart attack, heart failure, and pneumonia—reported to the Centers for Medicare and Medicaid Services (CMS) for the selection period (Exhibit 1).
Mercy Medical Center’s success may be attributed the following:
- a collaborative health care environment in which competitors work together to put patients first;
- primary focus on clinical excellence and standardized care, including an investment in advanced practice nurses to implement best practices and guidelines;
- early discharge planning, targeting of high-risk patients, and scheduling of follow-up care;
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telemonitoring and post-discharge phone calls for certain diagnoses; and
- strong end-of-life care that involves Palliative Care Teams, portable advance directives, and hospice care.
This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.