Physician Awareness of and Communication about Hospital Readmissions

1Brigham and Women's Hospital, Boston, MA
2Brigham and Women's Hospital, Boston, MA
3Brigham and Women's Hospital, Boston, MA
4Massachusetts General Hospital, Boston, MA
5Brigham and Women's Hospital, Boston, MA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 70

Background:

Patients recently discharged from inpatient medicine services often require hospital readmission and often are readmitted to a different physician or team, potentially without the knowledge of the prior caregivers. Thus, physicians may lose the opportunity to share valuable information about readmitted patients, which may be detrimental to continuity of care, patient safety, and resident education. It is unclear how often physicians are aware of readmissions or how often they communicate about them.

Methods:

In 2 academic medical centers, we prospectively identified patients who were discharged from the general medicine services and readmitted within 14 days. We excluded patients who were readmitted to the same physicians or whose readmission was planned. We surveyed all discharging and readmitting physicians 48 hours after the time of readmission and inquired about awareness of and communication related to the readmission. To identify predictors of physician communication, we fitted a logistic regression model with communication having occurred as the outcome variable.

Results:

Discharging team physicians were aware of fewer than half of 200 patient readmissions (48.5%, 95% CI 44.0%‐52.0%). Of those who were unaware, most (91.2%, 95% CI 88.7%‐93.7%) responded they would have wanted notification of the readmission. Of 222 patient readmissions with at least 1 survey response from the discharging or readmitting team, communication between teams occurred in 43.7% (95% CI 40.4%‐47.0%). When communication did occur, the readmitting team received information about the discharging team's overall assessment and discharge diagnosis (61.9%, 95% CI 56.9%‐66.9%), psychosocial issues (52.6%, 95% CI 47.6%‐57.6%), pending tests and follow‐up (34.0%, 95% CI 29.2%‐38.8%), and discharge medications (30.9%, 95% CI 26.2%‐35.6%). When communication did not occur, most physicians (60.8%, 95% CI 58.7%‐62.9%) responded that it would have been desirable to communicate. Higher medical complexity was associated with an increased likelihood of physician communication (OR 1.8, 95% CI 1.3‐2.3).

Conclusions:

Physicians are frequently unaware of patient readmissions and often do not communicate when readmissions occur. This communication is often desirable to physicians, and often results in the exchange of important patient information. Further work is needed to design systems to address this potential discontinuity of care.

Author Disclosure:

C. Roy, none; A. Kachalia, none; S. Woolf, none; A. Karson, none; T. Gandhi, none.

To cite this abstract:

Roy C, Kachalia A, Woolf S, Karson A, Gandhi T. Physician Awareness of and Communication about Hospital Readmissions. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 70. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/physician-awareness-of-and-communication-about-hospital-readmissions/. Accessed November 13, 2019.

« Back to Hospital Medicine 2008, April 3-5, San Diego, Calif.