Evaluation of an Intervention to Reduce Hospital Readmission Within 30 Days of Discharge

A hospitalist group of a local tertiary care academic hospital developed and implemented an intervention aimed at decreasing readmission rates. This intervention included a follow up appointment made before discharge and a follow up phone call by a nurse coordinator 2-3 days after discharge to evaluate how the patient was doing: if they were taking their medications, if they were feeling better, and make sure they went to or were planning on attending their follow up appointment. The purpose of this project was to formally evaluate this intervention to see if it reduced readmission to the hospital. Objectives of this project were to (a) Evaluate 30 day readmission rates in a pre- intervention group and a post- intervention group at a local tertiary care hospital, (b) share and discuss findings with the Hospitalist Team Lead at the local tertiary care academic hospital, (c) disseminate project to peers through profession poster or podium presentation. Readmissions within 30 days of discharge are common and costly to hospitals and patients. Medicare spends $17.4 billion annually on 30-day readmissions, and no longer reimburses hospitals for patients who are readmitted for the same diagnosis. Timely post-discharge follow-up is predicted to reduce 30-day readmission rates. After project approval I applied and received IRB approval. Pre- intervention and post- intervention participant charts were identified and reviewed and readmission rates were compared. Results showed a trend towards improvement in the post- intervention group, with a readmission rate of 16%, compared to the pre- intervention group, with a readmission rate of 22%. This was not found to be statistically significant (p-value 0.297). When analyzing readmission rates with the same diagnosis there was a statistically significant improvement in the post- intervention group with a p-value of 0.006. The project results were presented to the Hospitalist Team Lead and they will continue parts of the intervention. Finally an abstract was created and submitted to the 40th Annual Snowbird CME Conference. Readmissions are frequent and costly. Hospitals are working to reduce readmissions and a local community hospital identified the need to have a recent intervention formally evaluated. This project aims to address this need as well as to reveal greater insight on 30- day readmissions.