Preventing Hospital Readmissions: Healthcare Providers' Perspectives on "Impactibility" Beyond EHR 30-Day Readmission Risk Prediction.

Journal of General Internal Medicine
Natalie Flaks-ManovEfrat Shadmi

Abstract

Predictive models based on electronic health records (EHRs) are used to identify patients at high risk for 30-day hospital readmission. However, these models' ability to accurately detect who could benefit from inclusion in prevention interventions, also termed "perceived impactibility", has yet to be realized. We aimed to explore healthcare providers' perspectives of patient characteristics associated with decisions about which patients should be referred to readmission prevention programs (RPPs) beyond the EHR preadmission readmission detection model (PREADM). This cross-sectional study employed a multi-source mixed-method design, combining EHR data with nurses' and physicians' self-reported surveys from 15 internal medicine units in three general hospitals in Israel between May 2016 and June 2017, using a mini-Delphi approach. Nurses and physicians were asked to provide information about patients 65 years or older who were hospitalized at least one night. We performed a decision-tree analysis to identify characteristics for consideration when deciding whether a patient should be included in an RPP. We collected 817 questionnaires on 435 patients. PREADM score and RPP inclusion were congruent in 65% of patients, whereas 19% h...Continue Reading

References

Oct 19, 2011·Annals of Internal Medicine·Luke O HansenMark V Williams
Oct 20, 2011·JAMA : the Journal of the American Medical Association·Devan KansagaraSunil Kripalani
Jan 25, 2013·Israel Journal of Health Policy Research·Ran D BalicerAvi Israeli
Oct 29, 2013·Annual Review of Medicine·Sunil KripalaniEduard E Vasilevskis
May 14, 2014·JAMA Internal Medicine·Aaron L LeppinVictor M Montori
Jan 31, 2015·Medical Care·Efrat ShadmiRan D Balicer
Apr 4, 2017·Journal of the American Geriatrics Society·Mary D NaylorMark V Williams
Jun 28, 2019·BMC Medical Informatics and Decision Making·Natalie Flaks-ManovEfrat Shadmi

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Citations

May 2, 2020·JAMA : the Journal of the American Medical Association·Christopher J LindsellKevin B Johnson
Oct 31, 2020·Health Services Research·Ben J MarafinoMike Baiocchi
Feb 3, 2021·International Journal of Environmental Research and Public Health·Mei-Chin SuTzeng-Ji Chen
Sep 12, 2021·Journal of General Internal Medicine·Evelyn T ChangDavid Atkins
Oct 19, 2021·Journal of Nursing Management·Natalie Flaks-ManovEinav Srulovici

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