Preventable Readmissions to Surgical Services: Lessons Learned and Targets for Improvement

摘要: Background Hospital readmissions are under intense scrutiny as a measure of health care quality. The Center for Medicare and Medicaid Services (CMS) has proposed using readmission rates benchmark improving care, including targeting them nonreimbursable events. Our study aim was to describe potentially preventable after surgery identify targets improvement. Study Design Patients discharged from general service over 8 consecutive quarters (Q4 2009 Q3 2011) were selected. A working group attending surgeons defined terms created classification schemes. Thirty-day identified reviewed by 2-physician team. Readmissions categorized or unpreventable, target future quality improvement intervention. Results Overall rate 8.3% (315 3,789). most common indication initial admission elective surgery. Among readmitted patients in our sample, 28% did not undergo an operation during their index admission. Only 21% (55 258) likely based on medical record review. Of the readmissions, 38% within 24 hours 60% 48 hours. Dehydration occurred more frequently among (p Conclusions minority may be preventable. Targets reducing include addressing clinical issues infection dehydration well discharge planning limit both early short readmissions. Policies aimed at penalizing reimbursements should use data focus inappropriate hospitalization order promote high patient care.