Garnier, A.

Griesser, A.-C.

Lamy, O.

Lécureux, L.

Sartori, C.

English

Serveur académique lausannois

 P978Potentially avoidable readmissions: it worth to improve dischargesummary delivery delay A. Garnier1, E. Lécureux2, C. Sartori1, O. Lamy1, A.-C. Griesser21Internal Medicine Service, 2Medical Direction, University Hospital of Lausanne (CHUV), Lausanne,Switzerland Objective: Evidence shows that early readmissions may be increased by sub-optimal handover atdischarge to home. In 2012, readmission rate within 30 days was 18.55% in our Internal medicineservice. Potentially avoidable readmissions rate (not planned but caused by a known diagnosis) was9.79%, out of confidence interval of the expected rate (7.12% to 8.70%) according to patientcharacteristics.Exceeding delay of discharge summary (DS) dissemination can have an impact on successful transition.We deeply improved DS process in late 2012, and we hypothesized a decrease in potentially avoidablereadmissions.Methods: We completely reengineered DS production process and rapidly spread it to all units (173beds) during the last 4 months 2012. We built a system to monitor each step and prevent bottlenecks.Delay was measured from discharge day to mailing of DS. The impact on potentially avoidablereadmissions was calculated with SQLape® computerized algorithm from routine administrative data.Results: Median delay decreased significantly (Wilcoxon P< 0.001) from 22.2 days (mean 25.3; SD18.4) in 2012 to 18.1 days (mean 20.3; SD 12.1) in 2013. The potentially avoidable readmission ratedecreased of 1.74% to 8.05%. This bivariate decrease did not reach significance (p=0.09), but the ratelays now in the confidence interval for the expected rate (7.14% to 8.64%) (figure 1). Conclusion: Quality of transition is multimodal. Lowering DS delay is a key element that may preventpotentially avoidable readmissions. [Figure 1]

Potentially avoidable readmissions: it worth to improve discharge summary delivery delay

https://serval.unil.ch/resource/serval:BIB_7F443EE5BDB8.P001/REF.pdf

Potentially avoidable readmissions: it worth to improve discharge summary delivery delay

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