Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care

Mabel Labrada, Michael J. Mintzer, Chandana Karanam, Raquel Castellanos, Lorinda Cruz, Minh Hoang, Regina Wieger, Enrique Aguilar, Hermes J Florez, Jorge G. Ruiz

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives Thirty-day readmissions are common, serious, and costly. Most important, often they are preventable. The purpose of this quality improvement study was to evaluate an interdisciplinary, two-phase intervention to reduce 30-day readmissions among high-risk medical patients. One or two high-risk patients were selected each weekday by a hospitalist using literature-based, locally tested criteria that included common medical illnesses, active psychiatric illness, and recent or recurrent hospital admissions. Methods Patients admitted to 1 of 5 medical hospitalist teams were selected to receive the intervention; patients admitted to the 4 remaining teams were used for comparison. The two-phase care coordination intervention consisted of a daily interdisciplinary team meeting for the selected high-risk patients and postdischarge interventions that included outpatient care coordination until the patients' first follow-up appointment. The care plan addressed medical/geriatric assessment, social stability, medication reconciliation, nutritional needs, care coordination including future appointments/testing, and community services. Eighty-five patients in the intervention group were compared with 84 patients from the comparison group using propensity score matching. Patient characteristics were similar at baseline. Results The intervention group demonstrated a reduction in 30-day readmissions by 52% (11 vs 23, P = 0.019). Length of stay was reduced: 5.5 days compared with 7.2 days (P = 0.258). Conclusions This intervention produced a significant reduction in 30-day readmissions for high-risk patients and a trend for shorter lengths of stay compared with similarly matched patients. Future research trials are needed to verify these results.

Original languageEnglish (US)
Pages (from-to)757-760
Number of pages4
JournalSouthern Medical Journal
Volume110
Issue number12
DOIs
StatePublished - Dec 1 2017

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Hospitalists
Length of Stay
Appointments and Schedules
Medication Reconciliation
Geriatric Assessment
Propensity Score
Social Welfare
Ambulatory Care
Quality Improvement
Psychiatry

Keywords

  • 30-day readmissions
  • Acute care
  • High-risk medical patients
  • Interdisciplinary

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Labrada, M., Mintzer, M. J., Karanam, C., Castellanos, R., Cruz, L., Hoang, M., ... Ruiz, J. G. (2017). Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care. Southern Medical Journal, 110(12), 757-760. https://doi.org/10.14423/SMJ.0000000000000745

Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care. / Labrada, Mabel; Mintzer, Michael J.; Karanam, Chandana; Castellanos, Raquel; Cruz, Lorinda; Hoang, Minh; Wieger, Regina; Aguilar, Enrique; Florez, Hermes J; Ruiz, Jorge G.

In: Southern Medical Journal, Vol. 110, No. 12, 01.12.2017, p. 757-760.

Research output: Contribution to journalArticle

Labrada, M, Mintzer, MJ, Karanam, C, Castellanos, R, Cruz, L, Hoang, M, Wieger, R, Aguilar, E, Florez, HJ & Ruiz, JG 2017, 'Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care', Southern Medical Journal, vol. 110, no. 12, pp. 757-760. https://doi.org/10.14423/SMJ.0000000000000745
Labrada, Mabel ; Mintzer, Michael J. ; Karanam, Chandana ; Castellanos, Raquel ; Cruz, Lorinda ; Hoang, Minh ; Wieger, Regina ; Aguilar, Enrique ; Florez, Hermes J ; Ruiz, Jorge G. / Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care. In: Southern Medical Journal. 2017 ; Vol. 110, No. 12. pp. 757-760.
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