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29 QUALITY IMPROVEMENT & MEASUREMENT Discharging heart patients on weekends not linked to higher readmission rates, study finds By Harrison Cook D ischarging a cardiac surgery patient on a weekend or holiday does not affect hospital readmis- sion rates, according to a study published in The Annals of Thoracic Surgery. Here are three things to know: 1. For the study, researchers used the Soci- ety of oracic Surgeons' registry to iden- tify 4,877 adult patients who underwent an elective cardiac operation at Ronald Rea- gan UCLA Medical Center in Los Angeles between 2008-16. Researchers excluded emergency, transplant and mechanical assist patients from their analysis. 2. Twenty percent of the 4,877 patients were discharged on a weekend or holiday. The overall readmission rate was 11.3 percent. The hospital discharged more pa- tients to other facilities on weekdays (15 percent) than on weekends (5.7 percent). 3. Researchers found cardiac surgical patients discharged on weekends and holidays did not have significantly higher readmission rates. The readmission rate for cardiac surgery patients dis- charged on a weekday was 11.4 percent, compared to 10.9 percent for patients discharged on a weekend. "Cardiac surgical patients in the weekend and holiday discharge cohort did not have significantly higher odds of readmission regardless of operative type and discharge disposition," the researchers concluded. "Allocation of resources to changing weekend staffing may be better allocated to surgical site infection prevention and outpatient intervention programs." n IU Health forms 16 clinical councils to boost care quality By Mackenzie Bean I ndianapolis-based Indiana University Health developed 16 physician-led clinical councils this year to help improve care quality and reduce costs. The councils entail teams of six to 10 people, including clinicians, supply chain experts and information systems professionals. The councils, created for various clinical specialties, gather and analyze data to make decisions on drug formularies, medical order sets and some procedures. IU Health has already seen some cost containment improvements since forming the councils. The health system said pharmacy costs have stayed flat this year after increasing 7 percent or more annually for the past few years. Overall, IU Health aims to save $10 million in 2018. "This is the first year of the clinical councils in operation," Chris Weaver, MD, senior vice president of clinical effectiveness at IU Health, said in a statement emailed to Becker's. "They have driven physician engagement and leader- ship to make decisions at the specialist level. Overall it has gone well." The 16-hospital, 30,000-employee health system plans to eventually roll out 25 councils systemwide. n Readmission risk jumps 2.9% for every day spent in rural hospital By Harrison Cook H ealthcare facilities in rural cities across southern Appalachia report readmission rates well above the national average, in part due to increased length of stays and a patient population with a history of smoking and multiple comorbidities, according to a study published in CHEST. Here are four things to know: 1. Researchers reviewed 15,500 patient files for individuals admitted to hos- pitals in the southern Appalachia region from Jan. 1, 2014, to Oct. 31, 2017. To determine readmission rates, researchers used univariate analyses and regression modeling to assess the causes of frequent readmissions, consid- ering variables such as length of stay, age, gender and comorbidities. 2. The study authors found the likelihood of readmission increased by 2.9 percent for every day spent in these hospitals. 3. Former smokers were more likely than those who never smoked to be re- admitted to the hospitals. If patients were provided with smoking cessation education upon their discharge, the readmission rate decreased. 4. Patients diagnosed with chronic obstructive pulmonary disease, diabetes mellitus, hypertension, psychiatric disorders and chronic renal failure also demonstrated an increased readmission risk. "Some methods to prevent readmissions are decreasing length of stay ... providing smoking cessation education and controlling comorbid diagno- ses," lead study author Christine Moore, MD, said in a news release. n