The use of an automated notification system to identify and address early readmissions by a university hospitalist service.

OBJECTIVES

To examine the association of an automated physician feedback system prompting physician review of early readmissions with a change in overall readmission rates.

METHODS

The University of Utah Internal Medicine Hospitalist Service created an automated system to alert discharging providers to any patient readmitted within 30 days. For any 7-day readmission, the physician was asked to complete a survey to describe the admission and discharge and to identify contributing factors to the readmission. Using the University HealthSystem Consortium database, readmission rates were compared prior to and following this intervention.

RESULTS

Following the intervention, 30-day readmission rates significantly decreased from 13.93% to 11.99% (p = 0.0298). The 7-day readmission rates decreased as well but the findings were not statistically significant. The discharging physician deemed 45% of the readmissions preventable or probably preventable.

CONCLUSION

Readmissions are common, costly and potentially preventable. This tool for physician audit and feedback and identification of defects contributing to readmissions was associated with a statistically significant decrease in 30-day readmissions. Further investigation is needed to verify these results and evaluate the best mechanism of application.