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 language | English (US) |
|---|---|
| Pages (from-to) | 757-760 |
| Number of pages | 4 |
| Journal | Southern Medical Journal |
| Volume | 110 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 1 2017 |
Fingerprint
Keywords
- 30-day readmissions
- Acute care
- High-risk medical patients
- Interdisciplinary
ASJC Scopus subject areas
- Medicine(all)
Cite this
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 journal › Article
}
TY - JOUR
T1 - Dramatic reduction in 30-day readmissions through high-risk screening and two-phase interdisciplinary care
AU - Labrada, Mabel
AU - Mintzer, Michael J.
AU - Karanam, Chandana
AU - Castellanos, Raquel
AU - Cruz, Lorinda
AU - Hoang, Minh
AU - Wieger, Regina
AU - Aguilar, Enrique
AU - Florez, Hermes J
AU - Ruiz, Jorge G.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - 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.
AB - 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.
KW - 30-day readmissions
KW - Acute care
KW - High-risk medical patients
KW - Interdisciplinary
UR - http://www.scopus.com/inward/record.url?scp=85036617680&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85036617680&partnerID=8YFLogxK
U2 - 10.14423/SMJ.0000000000000745
DO - 10.14423/SMJ.0000000000000745
M3 - Article
C2 - 29197308
AN - SCOPUS:85036617680
VL - 110
SP - 757
EP - 760
JO - Southern Medical Journal
JF - Southern Medical Journal
SN - 0038-4348
IS - 12
ER -