Nurse Coordinator Readmission Rate Report Form
Nurse Coordinator Readmission Rate Report Form
Nurse Coordinator Full Name
*
First Name
Last Name
Reporting Period (Month/Year)
*
Hospital or Unit Name
*
Total Number of Discharges
*
Total Number of Readmissions
*
Calculated Readmission Rate (%)
*
Primary Reasons for Readmission (select all that apply)
Complications from initial condition
Medication issues
Discharge planning issues
Follow-up care gaps
Other
Interventions Taken to Prevent Readmission
Barriers or Challenges Encountered
Additional Comments or Suggestions
Submit Report
Should be Empty: