Skip to main content

All Content

Search Tips
Save
Selection
Format
Download
Published Date
Original Publication Date
Original Publication Date
PSNet Publication Date
Narrow Results By
1 - 18 of 18
Enumah SJ, Resnick AS, Chang DC. PLOS ONE. 2022;17:e0266696.
While quality and patient safety initiatives are implemented to improve patient outcomes, they also typically include a financial cost which must be balanced with expected outcomes. This study compared hospitals’ financial performance (i.e., financial margin and risk of financial distress) and outcomes (i.e., 30-day readmission rates, patient safety indicator-90 (PSI-90)) using data from the American Hospital Association and Hospital Compare. Hospitals in the best quintiles of readmission rates and PSI-90 scores had higher operating margins compared to the lowest rated hospitals.
El Abd A, Schwab C, Clementz A, et al. J Patient Saf. 2022;18:230-236.
Older adults are at high risk for 30-day unplanned hospital readmission. This study identified patient-level risk factors among patients 75 years or older who were initially hospitalized for fall-related injuries. Risk factors included being a male, abnormal concentration of C-reactive protein, and anemia. Discharge programs targeting these patients could reduce 30-day unplanned readmissions.
Muchiri S, Azadeh-Fard N, Pakdil F. J Patient Saf. 2022;18:237-244.
The Hospital Readmissions Reduction Program (HRRP), implemented by the Centers for Medicare & Medicaid Services (CMS), imposes a financial penalty on hospitals with higher than average readmission rates for certain conditions. Six years of readmission rates for four conditions included in the HRRP (acute myocardial infarction, chronic obstructive pulmonary disease, congestive heart failure, and pneumonia) and two conditions not included (septicemia and mood disorders) were analyzed to assess the impact of the HRRP. The researchers conclude the HRRP reduced readmission rates for the four targeted conditions, but reductions were not consistent across all categories of patients.
Damery S, Flanagan S, Jones J, et al. Int J Environ Res Public Health. 2021;18:7581.
Hospital admissions and preventable adverse events, such as falls and pressure ulcers, are common in long-term care. In this study, care home staff were provided skills training and facilitated support. After 24 months, the safety climate had improved, and both falls and pressure ulcers were reduced.
Singh D, Fahim G, Ghin HL, et al. J Pharm Pract. 2021;34:354-359.
Pharmacist-led medication reconciliation has been found to reduce medication discrepancies for some patients. This retrospective study examined the impact of pharmacist-conducted medication reconciliation among patients with chronic obstructive pulmonary disease (COPD). While pharmacist-conducted medication reconciliation identified medication dosing and frequency errors, it did not reduce 30-day readmission rates for patients with COPD.

The Patient Safe-D(ischarge) program used standardized tools to educate patients about their discharge needs, test understanding of those needs, and improve medication reconciliation at admission and discharge. A quasi-randomized controlled trial of the program found that it significantly increased patients' understanding and knowledge of their diagnoses, treatment, and required follow-up care.

Uitvlugt EB, Janssen MJA, Siegert CEH, et al. Front Pharmacol. 2021;12:567424.
Identifying and reducing potentially preventable readmissions is a patient safety priority. This study found that 16% of readmissions at one teaching hospital in the Netherlands were medication-related; of those, 40% were considered potentially preventable. Preventable readmissions were attributed to prescribing errors, non-adherence, and handoff or transition errors.
Field TS, Fouayzi H, Crawford S, et al. J Am Med Dir Assoc. 2021;22:2196-2200.
Transitioning from hospital to nursing home (NH) can be a vulnerable time for patients. This study looked for potential associations between adverse events (AE) for NH residents following hospital discharge and NH facility characteristics (e.g., 5-star quality rating, ownership, bed size). Researchers found few associations with individual quality indicators and no association between the 5-star quality rating or composite quality score. Future research to reduce AEs during transition from hospital to NH should look beyond currently available quality measures.

The Hospital at Homesm program provides hospital-level care (including daily physician and nurse visits, diagnostic testing, treatment, and other support) in a patient's home as a full substitute for acute hospital care for selected conditions that are common among seniors. Studies have shown that the Hospital at Home program results in lower length of stay, costs, readmission rates, and complications than does traditional inpatient care, and surveys indicate higher levels of patient and family member satisfaction than with traditional care.

Herges JR, Garrison GM, Mara KC, et al. J Am Pharm Assoc (2003). 2020;61:68-73.
The goal of medication reconciliation is to prevent adverse events by identifying unintended medication discrepancies during transitions of care. This retrospective cohort evaluated the impact of attending a pharmacist-clinician collaborative (PCC) visit after hospital discharge with their medication containers on risk of 30-day readmission. Among adult patients on at least 10 total medications, findings indicate no significant difference in 30-day hospital readmission risk between patients presenting to a PCC visit with their medication containers compared with patients who did not. However, when patients did present to their PCC visit with medication containers, pharmacists identified more medication discrepancies and resolved more medication-related issues.
Merkow RP, Shan Y, Gupta AR, et al. Jt Comm J Qual Patient Saf. 2020;46:558-564.
Postoperative complications can increase costs due to additional healthcare utilization such as further testing, reoperation, or additional clinical services. This study used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to estimate 30-day costs resulting from postoperative complications. Prolonged ventilation, unplanned intubation, and renal failure were associated with the highest cost per event, whereas urinary tract infection, superficial surgical site infection, and venous thromboembolism were associated with the lowest cost per event.
Raffel KE, Kantor MA, Barish P, et al. BMJ Qual Saf. 2020;29:971-979.
This retrospective cohort study characterized diagnostic errors among adult patients readmitted to the hospital within 7 days of hospital discharge. Over a 12-month period, 5.6% of readmissions were found to contain at least one diagnostic error during the index admissions. These diagnostic errors were primarily related to clinician diagnostic reasoning, including failure to order needed tests, erroneous interpretation of tests, and failure to consider the correct diagnosis. The majority of the diagnostic errors resulted in some form of clinical impact, including short-term morbidity and readmissions.

A 69-year-old man with cognitive impairment and marginal housing was admitted to the hospital for exacerbation of chronic obstructive pulmonary disease (COPD). After a four-day admission, the physician arranged for discharge and transport to residential care home and arranged for Meds-to-Beds (M2B), a service that collaborates with a local commercial pharmacy to deliver discharge medications to the bedside prior to the patient leaving the hospital.

Sunkara PR, Islam T, Bose A, et al. BMJ Qual Saf. 2020;29:569-575.
This study explored the influence of structured interdisciplinary bedside rounding (SIBR) on readmissions and length of stay. Compared to the control group, the odds of 7-day readmission were lower among patients admitted to a unit with SIBR (odds ratio=0.70); the intervention did not reduce length of stay or 30-day readmissions.
Weir DL, Motulsky A, Abrahamowicz M, et al. Health Serv Res. 2020.
This study examined the effect of medication regimen changes at hospital discharge on adherence and adverse events among older adults. At 30-days post-discharge, nearly half of patients were nonadherent to at least one medication change, 26% visited the emergency department, 6% were readmitted to the hospital, and 0.5% died. Patients who were non-adherent to all medication changes had a 35% higher risk of adverse events within 30-days post-discharge compared to those were adherent to all changes.
Hochman M, Bourgoin A, Saluja S, et al. Rockville, MD: Agency for Healthcare Research and Quality; March 2019. AHRQ Publication No. 18(19)-0055-EF.
Programs are in place to address hospital discharge process gaps that contribute to readmissions. This report summarizes research on primary care perspectives on reducing readmissions. Interventions identified include automated alerting to primary care providers when patients are hospitalized and the patient-centered medical home model.
Lacker C. Am J Nurs. 2011;111:65-69.
Analyzing data from the Pennsylvania Patient Safety Authority Reporting System, this commentary identifies contributing factors to readmissions and suggests tactics to prevent them.