Patients with a prior hospitalization in the last 6 months are at increased risk of readmission. However, given our current system of care, providers may be unaware that a patient was previously admitted to the hospital. Increasing awareness of readmissions can allow providers to focus on known strategies for reducing preventable readmissions.
(1) To understand attending, resident and nurse awareness of readmissions (2) To test simple strategies to increase awareness of readmitted patients, and (3) To determine the effects of increasing awareness on safe discharge processes and outcomes.
Baseline audits on readmission awareness were performed on the Medicine Service at a 600bed academic teaching hospital participating in Project BOOST. All residents received an introductory lecture on the importance of discharge safety in reducing readmissions. Over a two 2month period, 23 attendings, 20 residents, and 47 nurses were asked to identify patients under their care who had an admission to our hospital in the last 30 days. Attendings correctly identified 21/40 (53%) readmitted patients, residents 15/35 (43%), and nurses 10/22 (47%) of readmitted patients. To increase awareness of readmitted patients and to encourage discussion of risk factors at daily multidisciplinary rounds (MDR), we began by identifying patients readmitted to the hospital within 30 days through an administrative database. A large orange “R” sticker was placed on their paper chart on hospital day 1. During MDR, nurses were responsible for alerting attendees of readmitted patients. Starting in December 2011, serial audits of residents, attendings and nurses will identify any changes in awareness, and audits of PCP communication, timely follow up, change in discharge disposition and readmission rates will look for process and outcome changes. In March 2012, a second intervention will be implemented. The previous discharging team and the current admitting team will receive an email notifying them of a patient’s readmission status. This email will encourage them to discuss the reasons for readmission and strategies to prevent future readmission with the previous team and care coordination staff, as well as reminding them of the recorded process measures. AttendingsAttending on service will receive an educational module that they can complete with their team around one of their team’s readmissions. This educational module will review the literature and best practices around preventing readmissions. Subsequent audits of readmission awareness, process and outcome measures will be performed through June 2012.
When asked to identify readmissions, care providers were unaware of half of their readmitted patients. Our intervention will determine which strategies are effective in increasing provider awareness of readmissions, and if that awareness translates into improved discharge processes and outcomes.
To cite this abstract:Quinn K, Mourad M, Rennke S. Increasing Readmissions Awareness: What Will You Do Differently?. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97700. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/increasing-readmissions-awareness-what-will-you-do-differently/. Accessed May 27, 2019.