Preventing Readmissions after Surgery

BACKGROUND: The aim of this study was to evaluate the incidence, indications, and predictive factors of hospital readmission after open ventral hernia repair. METHODS: A retrospective review of all open ventral hernia repairs at a single institution from 2000 to 2010 was performed to assess readmissions between 1 to 30, 1 to 90, and 91 to 365 days. Multivariate analysis was performed to identify independent predictors of 30-day readmission. RESULTS: Of the 888 patients, 75 (8%) were readmitted between 1 and 30 days, 97 (11%) between 1 and 90 days, and 78 (9%) between 91 and 365 days...

BACKGROUND: Colon resections are associated with substantial risk for morbidity and readmissions, and these have become markers for quality of care. OBJECTIVE: The purpose of this study was to determine risk factors for readmissions after elective colectomies to improve patient care and better understand the complex issues associated with readmissions. DESIGN: This was an analysis of the prospective, statewide, multicenter Michigan Surgical Quality Collaborative database...

OBJECTIVE: Reducing hospital readmissions after adult cardiac surgery is necessary as part of the solution to achieving improved efficiency in health care. Patients who had undergone cardiac surgery were studied to develop strategies that may diminish the need for hospital readmission. METHODS: Over a 25-month period, 2096 patients underwent cardiac surgical procedures; 102 of these patients required readmission within 30 days of discharge. Time-matched patients (n = 249), not readmitted, served as a control group...

BACKGROUND: By focusing primarily on outcomes in the inpatient setting one may overlook serious adverse events that may occur after discharge (eg, readmissions, mortality) as well as opportunities for improving outpatient care. OBJECTIVE: Our overall objective was to examine whether experiencing an Agency for Healthcare Research and Quality Patient Safety Indicator (PSI) event in an index medical or surgical hospitalization increased the likelihood of readmission...

BACKGROUND: Readmissions are an attractive quality measure because they offer a broad view of quality beyond the index hospitalization. However, the extent to which medical or surgical readmissions reflect quality of care is largely unknown, because of the complexity of factors related to readmission. Identifying those readmissions that are clinically related to the index hospitalization is an important first step in closing this knowledge gap. OBJECTIVES: The aims of this study were to examine unplanned readmissions in the Veterans Health Administration, identify clinically related versus unrelated unplanned readmissions, and compare the leading reasons for unplanned readmission between medical and surgical discharges...

BACKGROUND: Total hip arthroplasty (THA) is a beneficial and cost-effective procedure for patients with osteoarthritis. Recent initiatives to improve hospital quality of care include assessing unplanned hospital readmission rates. Patients presenting for THA have different indications and medical comorbidities that may impact rates of readmission. QUESTIONS/PURPOSES: This study measured (1) the unplanned hospital readmission rate in primary THA, revision THA, and antibiotic-spacer staged revision THA to treat infection...

BACKGROUND: Total knee arthroplasty (TKA) and related interventions such as revision TKA and the treatment of infected TKAs are commonly performed procedures. Hospital readmission rates are used to measure hospital performance, but risk factors (both medical and surgical) for readmission after TKA, revision TKA, and treatment for the infected TKA have not been well characterized. QUESTIONS/PURPOSES: We measured (1) the unplanned hospital readmission rate in primary TKA and revision TKA, including antibiotic-spacer staged revision TKA to treat infection...

BACKGROUND: Warnings of deteriorating condition provided to patients at hospital discharge are highly subjective, based on conventional wisdom, and lack systematic implementation. We conducted a standardized Delphi process to achieve national consensus on warning indicators and recommended action plans for patients after colorectal surgery. STUDY DESIGN: Expert panel eligibility was determined by pre-established criteria. A preliminary meeting was held at a national surgical conference followed by 5 rounds of email questionnaires and 1 teleconference using the Delphi method...