Becker's Clinical Quality & Infection Control

24 READMISSION REDUCTION 30% of Children's Hospital Readmissions May Be Preventable By Brian Zimmerman N early 30 percent of 30-day readmis- sions at Boston Children's Hospital may have been preventable, accord- ing to a new study published in the journal Pediatrics. For the study, researchers examined the medical records of 305 children readmitted within 30 days of discharge between Decem- ber 2012 and February 2013. e researchers also conducted interviews with clinicians and patients' families. Researchers determined that 29.5 percent of these readmissions may have been preventable. Of the potentially preventable readmissions, 39.2 percent were related to factors attributable to patient issues that arose aer discharge. Hospital factors played a role in more than 75 percent of 30-day readmissions. Multiple factors played a role in the readmission of certain patients, so when considering all factors together the total exceeds 100 percent. Researchers identified the excessive opti- mism of both clinicians and family members aer a patient's discharge as a potential contributing factor to readmission. According to Kaiser Health News, Sara Toomey, MD, the study's lead author and the medical director of patient experience at Boston Children's Hospital, said, "One of the things we need to improve upon is engaging families at the time of discharge around how we're feeling and how they're feeling about the status of the child at that point in time...when you have a child coming home from the hospital, there are things you need to know, and the more active people are in creating a plan and making sure they understand it, the better that will help their children." n Initiatives Aimed at Lowering Hospital Admissions Also Lower Readmissions, Study Finds By Brian Zimmerman P rograms that include strategies to simultaneous- ly lower hospital admissions and readmissions can be successful in communities where pa- tients tend to be sicker when hospitalized, according to a study published in Health Affairs. For the study, researchers analyzed Medicare data collected from communities with hospitals that are major referral centers in 2010 and 2013. Using the data, researchers calculated both admission and readmission rates for each community. While hospital groups and policymakers have ex- pressed concern regarding CMS programs that seek to lower both admissions and readmissions, citing the creation of a sicker hospitalized population with worse outcomes and increased readmission rates as a potential downfall, researchers found that a reduction in hospital admissions was strongly associated with a reduction in 30-day readmissions. Kumar Dharmarajan, MD, assistant professor of cardiology at Yale University in New Haven, Conn., and the study's first author, said, "We're showing that communities can do a good job of improving both population health and outcomes after hospitalization. These goals are not in conflict." n New App Could Lead to Big Savings by Reducing Readmissions By Brian Zimmerman G raduate students from Binghamton (N.Y.) University have created an Android-based mobile application designed to help hospitals reduce 30-day readmission rates and save money by avoiding penalties. The app, Post Discharge Treatment and Readmission Predic- tor, determines whether a patient is at high risk for readmis- sion with an algorithm influenced by hospital readmission re- search conducted by assistant professors of systems science and industrial engineering at the university. It also features a direct line of communication from patient to provider. "For this app, predicting the readmission rate is only one part. The other part of this app is instant communication between the doctor/nurse and the patient," said one of the app's creators, Amirhosein Gholami. "The patient can send infor- mation directly to the healthcare provider and, based on the new information, the provider can predict the new readmis- sion rate and send some instructions to the patient to take this medicine, to do this, etc." The app garnered second place accolades in the nationwide 2016 Institute of Industrial and System Engineers CIS Division Mobile App Competition. The creators of the app believe the product has high levels of commercial viability. "I don't see anything similar to it on the market," said Mr. Gholami. "If it can help to prevent even just 10 percent of patients from being rehospitalized, it's big money." n

• Cover