Readmissions: A Missed Learning Opportunity for Hospitalists

1Johns Hopkins Bayview Medical Center. Collaborative Inpatient Medicine Service, Baltimore, MD
2Johns Hopkins Hospital. Division of General Internal Medicine—hospitalist program, Baltimore, MD
3Johns Hopkins Bayview Medical Center. Division of General Internal Medicine, Baltimore, MD

Meeting: Hospital Medicine 2011, May 10-13, Dallas, Texas.

Abstract number: 25

Background:

Hospitalists are often not aware when a patient whom they have cared for is readmitted to the hospital. However, there may be much to learn from readmissions, both in terms of clinical care and systems improvement. To this end, we asked hospitalists how they learn when a patient has been readmitted, what they do when they hear of these cases, and to what extent they view readmissions as opportunities for professional growth.

Methods:

As part of an ongoing institution review board–approved intervention focused on medical professionalism, we conducted a cross‐sectional survey of 27 hospitalists. Respondents were contacted by e‐mail and responded via an electronic survey. Respondents were queried about their attitudes regarding learning and professionalism opportunities from readmissions. Attitude responses were assessed with a 5‐point Likert‐type scale that ranged from “strongly disagree” to “strongly agree.” In addition, respondents were queried about how they learned of a patient's readmission and about behaviors they demonstrated once this knowledge was obtained. Behavior responses were assessed using a 5‐point Likert‐type scale that ranged from “always” to “never.” Data were analyzed using descriptive statistics. Results are reported as the percentage of respondents who chose “agree” or “strongly agree” for attitude responses versus “usually” or “always” for behavior responses.

Results:

Twenty‐seven hospitalists completed the questionnaire (100% response rate). Forty‐eight percent were male, and 74% had worked within the hospitalist group > 1 year. Ninety percent of respondents agreed that learning of readmissions could help them become “more skilled and effective physicians.” Ninety percent of respondents agreed that learning why patients are readmitted “is an act of professionalism for hospitalists.” Respondents learned of readmissions multiple ways: 89% learned of the event accidentally (e.g., noticing the patient's name on a door), 48% from the readmitting provider, 7% from the patient/patient's family, and 30% through “other” channels (e.g., “the case manager informs me”). Once a provider learned of a patient readmission, 41% communicated with the patient's current provider, and 41% visited the readmitted patient.

Conclusions:

Hospitalists recognize that committing the time and effort to learn why a patient has been readmitted is both an act of professionalism and an opportunity for clinical learning through deliberate practice. When they do learn that their patients have been readmitted, a sizable minority communicate directly with the current providers or with the patients—steps that enhance individual learning and improve patient care. Unfortunately, this is often a missed opportunity, as hospitalists are frequently unaware that a patient has been readmitted. Establishing formal processes to inform hospitalists of patient readmissions may contribute to improved clinical skill and inpatient care.

Disclosures:

J. Bracey ‐ none; R. Boonyasai ‐ none; S. Wright ‐ none

To cite this abstract:

Bracey J, Boonyasai R, Wright S. Readmissions: A Missed Learning Opportunity for Hospitalists. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 25. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/readmissions-a-missed-learning-opportunity-for-hospitalists/. Accessed April 25, 2019.

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