Preventing Preventable Readmissions

Important patient safety issues in hospitals

Wrong-Site Surgery Hand hygiene Hospital-Acquired

Infections

Surgical site infections

Hospital-acquired pneumonia

Catheter-related bloodstream

infections

Hospital readmissions

Falls (inpatient)

Diagnostic Errors

Medication Errors

What is hospital readmission?

Preventable

•Defined as subsequent inpatient admission to any acute care facility which occurs within 30 days of the discharge date of

previous admission.

Non-preventable

•A planned (intentional) readmission that is a scheduled part of the

patient’s plan.

How big is the problem!!Readmission rates

According to UptoDate:

There were over 39 million hospital discharges in the United States in 2006.

Almost 20 percent who are discharged from a hospital are readmitted within 30 days.

While the exact number of avoidable readmissions is unknown, between 9 and

50 percent of readmissions were judged to be preventable in studies involving retrospective chart review.

Causes of preventable readmissions

Hospital- related

Management- related

Patient- related

•Poor use of health information technology (e.g., electronic health records and patient registries).

•Poor post-discharge services.•Complications following procedures.

•Inadequate medical management.•Premature discharge.

•Poor patient education.•Complications following procedures.

•Poor understanding of condition .•Poor compliance.

•Poor follow up appointments.•Medication related issues.

Preventing Preventable Readmissions Study

Abstract

BACKGROUND :Discharge checklist and post-discharge phone call are routine features of health systems in many countries. The aim is to reduce unplanned readmission to hospital, help preventing patient related causes of readmission and to improve patient safety.

.

OBJECTIVES: To determine the effectiveness of dis-charge checklist and post-discharge phone call.

METHODS: Making brochures for patient education about the most common conditions known to be readmitted worldwide (HF-sepsis) plus DM and Asthma which are common in KSA.

Applying discharge planning checklist given to the patients who are preparing to leave the hospital which consists of their: - diagnosis.- health care provider contact information. - important points to be discussed with the doctor before discharge.- the next appointment and investigations required.

- drug list .

Post-discharge phone call within 72 hours of discharge and another

call will be done after 7 days.

72

PATIENT SELECTION CRITERIA:

*Admitted with heart failure, DM, asthma or sepsis (if available).

*Speaks and understands Arabic or English.

*Cooperative.

*If he/she is dependent, there must be a care-giver.

*To be discharged on the same day of selecting him/her or on the next day.

*Willing to give verbal consent of a phone number for contact.

Day 3 PDC Day 7 PDC0

2

4

6

8

10

12

14

16

18

Treatment adherenceComplications & InfectionsReadmission

RESULTS:

Checklist is helpful in understanding rights

Checklist is helpful in remembering medications

Checklist is helpful in remembering your appointments

Phone call is helpful in answering questions and concerns

Satisfaction with the post-discharge phone call overall

0 2 4 6 8 10 12 14 16 18

No

Maybe

Yes

CONCLUSION: The period between discharge and follow-up appointment is a vulnerable period of discontinuity and potential adverse events. A discharge checklist and a post discharge phone call can play an important role in bridging the gap between inpatient and outpatient care.

872179 Norah Basheer AL-Mutairi872198 Manal Saleh AL-Saleh872195 Raneem AL-Fateh AL-Sayed872027 Razan Abed Baloush872199 Leyan Naseer al-deen Khyrudeen872203 Heba Kamal Salim872209 Esra'a Talal Komah872324 Eqan Abdullah Ahmed872327 Malak Hassan AL-Qarni872272 Nada Ibrahem Bin Merdah744539 Rehab Ali AL-Yamani0405050 Fatima Ahmed AL-Gharadh

SupervisiorDr. Reem Al-Affari

Group 4-B

Thank you