Complications following surgery are a strong indicator of which patients are likely to be readmitted to the hospital in the 30 days following their procedure, according to a study published in JAMA Surgery. Using an online tool may allow healthcare professionals to flag patients at high risk of readmission in real time and alter care to reduce expensive trips back to the hospital.
Researchers examined more than 142,000 patients who had non-cardiac surgery using the American College of Surgeons National Surgical Quality Improvement Program database. After controlling for severity of disease and surgical complexity, analyses showed that:
- The rate of unplanned 30-day readmissions was approximately 78 percent for patients with any complication diagnosed following discharge from the hospital.
- Conversely, the rate of unplanned 30-day readmissions was less than 5 percent for patients without any complications.
Currently, hospitals do not have a way to identify surgical patients who are at high risk for unplanned re-hospitalizations. The online tool — the American College of Surgeon’s Surgical Risk Calculator — allows healthcare professionals to enter patient information like age, body mass index and smoking status and get an estimate of the patient’s risk of complications following surgery.
Patients at high risk of complications could also be more closely monitored after they are discharged from the hospital and sent home in order to uncover and treat surgical complications earlier in their course, before patients require re-hospitalization.
Hospital readmissions are believed to be an indicator of inferior care and are the focus of efforts by the Centers for Medicare and Medicaid Services (CMS) to reduce healthcare cost and improve quality. Researchers believe that measuring the end products of healthcare, such as death, complications and re-hospitalizations, and reporting that information after the fact to healthcare professionals, patients and third-party payors in the form of report cards, may not be sufficient to achieve the best possible outcomes. Professionals can also add information about a patient’s likelihood of complications to his or her electronic medical record (EMR) and use before, during and following surgery to help guide clinical decision making.
This is the first study to examine the association between the risk of complications after surgery and the rate of unplanned re-hospitalizations in a large, nationally representative sample of patients undergoing general surgery. Incorporating information from the American College of Surgeons National Surgical Quality Improvement Program and Surgical Risk Calculator into the daily workflow of healthcare teams in hospitals across the country could help achieve CMS’s goal to reduce hospital readmissions and generate savings in healthcare costs in the coming years.
Source: University of Rochester Medical Center, March 6, 2014
5 Best Practice Prevention Protocols for Reducing Readmissions highlights Torrance Memorial Health System’s network of SNFs and home health — part of its award-winning five-pronged approach to curbing rehospitalizations. In this 30-page special report, Josh Luke, Ph.D., FACHE, vice president of post-acute services at Torrance Memorial Health System, highlights the five key initiatives that comprise his organization’s Total Wellness Torrance (TWT) readmission prevention program.