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  1. Panozzo, Gina L. DNP, RN-BC
  2. Rossetti, Jeanette EdD, MS, RN
  3. Hess, Katherine MS, RN-BC


To address rehospitalization rates and emergency department rates that were above the state and national averages, a quality improvement project was implemented at a midsized home healthcare agency. In order to address these escalating rates, the Home Health Universal Best Practice Protocol was developed and implemented by a home healthcare consultant. The protocol is evidence-based, time-specific, comprehensive, and includes interventions that are linked to reducing avoidable hospital visits. Interventions include risk assessment for rehospitalization, initiation of telehealth, utilization of teach-back method, and timely documentation. The Home Health Universal Best Practice Protocol was effective in not only exceeding objectives regarding decreasing rehospitalization and emergency department rates within a 6-month period but also in improving home healthcare agency referral rates.