Reducing Readmission Rates at a Large Academic Otolaryngology Practice

Abstract

Objectives:

Hospital readmissions are an important focus of national quality and cost containment efforts. With increased emphasis on readmissions in the current healthcare climate, it is critical to evaluate factors contributing to readmission rates and strategies aimed at reducing these rates. The objectives of this study are to analyze the reasons for hospital readmission within 30 days of discharge and discuss methods implemented to reduce readmissions.

Methods:

A retrospective chart analysis was performed from 2010 to 2012 at a tertiary-care medical center. A quality plan was developed and implemented during this time to reduce readmissions. All patients who were admitted to an otolaryngology inpatient service and readmitted within 30 days of discharge were identified.

Results:

There were 763, 820, and 804 admissions during the years 2010, 2011, and 2012, respectively. The number of readmissions during this time were 51 (6.7%), 54 (6.6%), and 28 (3.5%), respectively. Common diagnoses for readmissions included dehydration, syncope, venous thromboembolism, postoperative bleeding, and cellulitis. There were no statistically significant differences in demographics and subsequent length of stay for those patients requiring readmission. The reduction in number of readmissions in 2012 compared to 2011 and 2010 was statistically significant.

Conclusions:

Readmission within 30 days in a large otolaryngology practice can be multifactorial. In order to reduce rates of readmission it is essential to understand post-operative complications, diagnoses, and comorbidities contributing to readmission. Implementation of a quality plan comprising comprehensive discharge planning efforts and close post-discharge follow-up can lead to a reduction in readmissions.