Utilization of a multidisciplinary hospital-based approach to reduce readmission rates
Background: Hospital readmissions remain a significant and pressing issue in our healthcare system. In 2010, the Affordable Care Act helped establish the Hospital Readmissions Reduction Program, which incentivized reducing readmission rates by instituting penalties. Hospital readmission, specificall...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-01-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121241226591 |
| _version_ | 1797305188272308224 |
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| author | Barry Hahn Trever Ball Wassim Diab Chris Choi Hallie Bleau Anne Flynn |
| author_facet | Barry Hahn Trever Ball Wassim Diab Chris Choi Hallie Bleau Anne Flynn |
| author_sort | Barry Hahn |
| collection | DOAJ |
| description | Background: Hospital readmissions remain a significant and pressing issue in our healthcare system. In 2010, the Affordable Care Act helped establish the Hospital Readmissions Reduction Program, which incentivized reducing readmission rates by instituting penalties. Hospital readmission, specifically unplanned, refers to a patient returning to the hospital shortly after discharge due to the same or a related medical condition, signaling potential issues in initial care, discharge processes, or post-hospitalization management. For this study, we defined readmission as a return to the hospital within 30 days. In 2018, Staten Island University Hospital started a multidisciplinary and coordinated initiative to reduce patient readmissions. The approach involved the departments of emergency medicine, medicine, cardiology, case management, nursing, pharmacy, and transitional care management. This study aimed to determine if this approach reduced 30-day readmissions. Methods: This case-control retrospective study reviewed electronic health records between January 2018 and November 2019. Readmission rates within 30 days of index discharge were compared between patients who received transitional care management before and after establishing a multidisciplinary communication of transitional care. Readmission rates were unadjusted and adjusted for patient demographics and predisposed risk for readmission and compared across demographics and select clinical characteristics. Results: A total of 772 patients were included in the analyses; 323 were in the control group (41.8%), and 449 were in the intervention group (58.2%). After the hospital adopted the workflow for multidisciplinary communication of transitional care, there was 45.2% less adjusted incidence of readmission, or approximately seven fewer overall readmissions per 100 patients (16.4% readmission vs 9.0% readmission; incident rate ratio, 0.55; 95% CI: 0.34–0.88). Conclusions: Multidisciplinary communication approaches led by emergency medicine can help reduce readmissions significantly. Adopting a structured communication workflow can enhance co-managing patients with a high risk of readmission between the emergency department and hospital medicine teams. |
| first_indexed | 2024-03-08T00:21:39Z |
| format | Article |
| id | doaj.art-1d68ca7661244226b98ddde18d9b09e7 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-03-08T00:21:39Z |
| publishDate | 2024-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-1d68ca7661244226b98ddde18d9b09e72024-02-16T05:03:18ZengSAGE PublishingSAGE Open Medicine2050-31212024-01-011210.1177/20503121241226591Utilization of a multidisciplinary hospital-based approach to reduce readmission ratesBarry Hahn0Trever Ball1Wassim Diab2Chris Choi3Hallie Bleau4Anne Flynn5Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, USANorthwell, Health Solutions Population Healthcare Management, Manhasset, NY, USADepartment of Medicine, Staten Island University Hospital, Staten Island, NY, USANorthwell, Health Solutions Population Healthcare Management, Manhasset, NY, USANorthwell, Health Solutions Population Healthcare Management, Manhasset, NY, USANorthwell, Health Solutions Population Healthcare Management, Manhasset, NY, USABackground: Hospital readmissions remain a significant and pressing issue in our healthcare system. In 2010, the Affordable Care Act helped establish the Hospital Readmissions Reduction Program, which incentivized reducing readmission rates by instituting penalties. Hospital readmission, specifically unplanned, refers to a patient returning to the hospital shortly after discharge due to the same or a related medical condition, signaling potential issues in initial care, discharge processes, or post-hospitalization management. For this study, we defined readmission as a return to the hospital within 30 days. In 2018, Staten Island University Hospital started a multidisciplinary and coordinated initiative to reduce patient readmissions. The approach involved the departments of emergency medicine, medicine, cardiology, case management, nursing, pharmacy, and transitional care management. This study aimed to determine if this approach reduced 30-day readmissions. Methods: This case-control retrospective study reviewed electronic health records between January 2018 and November 2019. Readmission rates within 30 days of index discharge were compared between patients who received transitional care management before and after establishing a multidisciplinary communication of transitional care. Readmission rates were unadjusted and adjusted for patient demographics and predisposed risk for readmission and compared across demographics and select clinical characteristics. Results: A total of 772 patients were included in the analyses; 323 were in the control group (41.8%), and 449 were in the intervention group (58.2%). After the hospital adopted the workflow for multidisciplinary communication of transitional care, there was 45.2% less adjusted incidence of readmission, or approximately seven fewer overall readmissions per 100 patients (16.4% readmission vs 9.0% readmission; incident rate ratio, 0.55; 95% CI: 0.34–0.88). Conclusions: Multidisciplinary communication approaches led by emergency medicine can help reduce readmissions significantly. Adopting a structured communication workflow can enhance co-managing patients with a high risk of readmission between the emergency department and hospital medicine teams.https://doi.org/10.1177/20503121241226591 |
| spellingShingle | Barry Hahn Trever Ball Wassim Diab Chris Choi Hallie Bleau Anne Flynn Utilization of a multidisciplinary hospital-based approach to reduce readmission rates SAGE Open Medicine |
| title | Utilization of a multidisciplinary hospital-based approach to reduce readmission rates |
| title_full | Utilization of a multidisciplinary hospital-based approach to reduce readmission rates |
| title_fullStr | Utilization of a multidisciplinary hospital-based approach to reduce readmission rates |
| title_full_unstemmed | Utilization of a multidisciplinary hospital-based approach to reduce readmission rates |
| title_short | Utilization of a multidisciplinary hospital-based approach to reduce readmission rates |
| title_sort | utilization of a multidisciplinary hospital based approach to reduce readmission rates |
| url | https://doi.org/10.1177/20503121241226591 |
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