On Wednesday a group of hospital administrators, doctors, nurses, nursing home workers and others will gather at the Union League in Philadelphia to launch an initiative aimed at reducing costly readmissions by 10 percent in over the next 18 months.

The Partnership for Patient Care, collaboration between the general hospitals and health systems in Southeastern Pennsylvania and Independence Blue Cross, the region's largest health insurer, begin the collaborative effort that targets key aspects of the hospital discharge process.

Three working groups will focus on elements of that process that can lead to problems and patients returning to the hospital. A key to ensuring smooth transitions for patients out of the hospitals is to ensure that they know and understand their medication regimens and that they are clear on what medications they should be and shouldn't be taking.

Another working group will examine communications among the hospitals, patients and other providers such as primary care doctors, nursing homes and home health agencies. And the third group will delve into the issues around personal health records and boosting efforts to make sure patients know and understand how to manage their own care.

"This is a really key issue from a quality of care perspective," said Vic Caraballo, senior medical director for Quality Management at Independence which committed $4.25 million to the partnership from 2006 through 2011. "The core the problem of readmissions is breaks down into a lot of different areas … we are taking a real comprehensive approach."

Caraballo said the effort worked well with other Independence initiatives including its recent decision to boost incentive payments to primary care doctors who achieve specified quality goals in their practices.

Area hospitals have contributed $1.7 million to the partnership which has sought to reduce preventable hospital infections and other patient safety issues since it was established in 2006.

Kate Flynn of the Health Care Improvement Foundation, an offshoot of the trade group for the hospitals in Philadelphia and the four suburban Pennsylvania counties, said the effort was different from earlier safety initiatives because success depends on hospitals and other organizations working together to address the readmission problem.

Studies have shown that about one in five Medicare patients return to the hospital within 30-days of being discharged. And data from the Pennsylvania Health Care Cost Containment Council show similarly high rates of readmissions for all patients, Flynn said.

"Efforts can and need to be made to bring those numbers down," she said. "Our program on Wednesday will feature … a lot of interesting innovative practices to share for other people to pilot or adopt and hopefully that can really accelerate the pace of change in addressing this problem."