Association of Self-reported Hospital Discharge Handoffs With 30-Day Readmissions

Oduyebo, Ibironke; Lehmann, Christoph U.; Pollack, Craig Evan; Durkin, Nowella; Miller, Jason D.; Mandell, Steven F.; Ardolino, Margaret; Deutschendorf, Amy; Brotman, Daniel J.

doi:10.1001/jamainternmed.2013.3746

Cited by 50 publications

(58 citation statements)

References 25 publications

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“…Fourteen of the 20 (70 %) articles 15,16,[21][22][23][24][27][28][29][30][31][32][33][34] reported quantitative results on the occurrence of provider-to-provider communication ( Table 2).…”

Section: Provider-to-provider Communication Quantitative Resultsmentioning

confidence: 99%

“…1): 13 cross-sectional studies, [15][16][17][18][19][20][21][22][23][24][25][26][27] four cohort studies, [28][29][30][31] two randomized controlled trials, 32,33 and one quasi-experimental study 34 (Table 1). Studies were conducted in the US (n=11), [15][16][17][18][19][20][21]24,28,29,34 Australia (n=6), 22,25,[30][31][32][33] and United Kingdom (n=3). 23,26,27 Most studies evaluated the transition from outpatient clinic to hospital admission (n=9).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…16,19,[21][22][23]25,27,28,32 Other described transitions included nursing home to the emergency department (four studies), 17,18,20,34 clinic to the emergency department (four studies), 26,30,31,33 and three from an unspecified site to hospital admission. 15,24,29 Overall, the majority of the acute care settings involved are individual hospitals. 15,16,19,[21][22][23][24][25]27,28,30,32,33 Three studies noted academic centers as the acute care setting 15,16,19 and four other studies described a Bdistrict hospital's^involve-ment.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…15,24,29 Overall, the majority of the acute care settings involved are individual hospitals. 15,16,19,[21][22][23][24][25]27,28,30,32,33 Three studies noted academic centers as the acute care setting 15,16,19 and four other studies described a Bdistrict hospital's^involve-ment. 23,27,30,33 None of the studies reviewed clearly stated that the study involved integrated health systems (see Table 1).…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Table 2). Among those 13 studies, eight described communication with an inpatient medical provider (62 %), 15 32 and one study did not specify the acute care provider (8 %). 29 One additional study reported communication between the nursing home staff and the emergency department staff.…”

Section: Frequency Of Communicationmentioning

confidence: 99%

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Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review

et al. 2015

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BACKGROUND: Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care. METHODS: We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool. RESULTS: Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65 %), conducted in the US (55 %), and studied communication between primary care and inpatient providers (62 %). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95 % CI 0.92-1.26). DISCUSSION: The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.KEY WORDS: care transitions; continuity of care; provider-to-provider communication.

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“…Fourteen of the 20 (70 %) articles 15,16,[21][22][23][24][27][28][29][30][31][32][33][34] reported quantitative results on the occurrence of provider-to-provider communication ( Table 2).…”

Section: Provider-to-provider Communication Quantitative Resultsmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Frequency Of Communicationmentioning

confidence: 99%

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Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review

et al. 2015

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Complexity Science and the Readmission Dilemma

Marks

2013

JAMA Intern Med

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Association of impaired functional status at hospital discharge and subsequent rehospitalization

Hoyer

Needham

Atanelov

et al. 2014

Journal of Hospital Medicine

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158

146

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OBJECTIVE To determine whether functional status near the time of discharge from acute care hospitalization is associated with acute care readmission. PATIENTS AND METHODS Retrospective cohort study of 9405 consecutive patients admitted from an acute care hospital to an inpatient rehabilitation facility between July 1, 2006 and December 31, 2012. Patients’ functional status at admission to the rehabilitation facility was assessed by the Functional Independence Measure (FIM) score, and divided into low, middle, or high functional status. The main outcome was readmission to an acute care hospital within 30 days of acute care discharge (for all patients and by subgroup according to diagnostic group: medical, orthopedic, or neurologic). RESULTS There were 1182 (13%) readmissions. FIM score was significantly associated with readmission, with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for low and middle versus high FIM score category of 3.0 (2.5-3.6; P < 0.001) and 1.5 (95% CI: 1.3-1.8; P < 0.001), respectively. This relationship between FIM score and read-mission held across diagnostic category. Medical patients with low functional status had the highest readmission rate (OR: 29%; 95% CI: 25%-32%) and an adjusted OR for readmission of 3.2 (95% CI: 2.4-4.3, P < 0.001) compared to medical patients with high FIM scores. CONCLUSIONS AND RELEVANCE For patients admitted to an acute inpatient rehabilitation facility, functional status near the time of discharge from an acute care hospital is strongly associated with acute care readmission, particularly for medical patients with greater functional impairments. Reducing functional status decline during acute care hospitalization may be an important strategy to lower readmissions.

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Association of Self-reported Hospital Discharge Handoffs With 30-Day Readmissions

Cited by 50 publications

References 25 publications

Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review

Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review

Complexity Science and the Readmission Dilemma

Association of impaired functional status at hospital discharge and subsequent rehospitalization

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