Quality

Focus on patient experience to cut readmission rates

Incorporate patient-reported quality measures


 

Hospitalists have focused much attention on reducing 30-day readmission rates, at a time when 15-20% of health care dollars spent on those readmissions is considered potentially preventable.

But until very recently, no study has explored patient perceptions of the likelihood of readmission during index admission. Now, that’s changed.

“Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission,” says Jocelyn Carter, MD, of Massachusetts General Hospital, Boston, and lead author of November 2017 study in BMJ Quality & Safety.

Enrolled in the study were 846 patients at two inpatient adult medicine units at Massachusetts General, Boston; 201 (23.8%) of these patients were readmitted within 30 days. In multivariable models adjusting for baseline differences, respondents who reported being “very satisfied” with the care received during the index hospitalization were less likely to be readmitted; participants reporting that doctors “always listened to them carefully” also were less likely to be readmitted.

“These findings are important since they suggest that engaging patients in an assessment of communication quality, unmet needs, concerns, and overall experience during admission may help to identify issues that might not be captured in standard postdischarge surveys when the appropriate time for quality improvement interventions has passed,” Dr. Carter said. “Incorporating patient-reported measures during index hospitalizations may improve readmission rates and help predict which patients are more likely to be readmitted.”

Reference

Carter J et al. The association between patient experience factors and likelihood of 30-day readmission: A prospective cohort study. BMJ Qual Saf. 16 Nov 2017. Accessed Feb 2, 2018.

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