Intensive care unit readmission prevention checklist: Is it worth the effort?

Nathan J. Smischney, Kelly A. Cawcutt, John C. O'Horo, Ronaldo A. Sevilla Berrios, Francis X. Whalen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Rationale, aims and objectives Checklists have been adopted by various institutions to improve patient outcomes. In particular, readmission prevention checklists may be of potential value to improve patient care and reduce medical costs. As a result, a prior quality improvement study was conducted to create an intensive care unit readmission prevention checklist. The previous pilot demonstrated zero readmissions when the readmission prevention checklist was utilized but yielded low compliance (30%). Thus, a subsequent quality initiative was undertaken to refine the readmission prevention checklist with the primary aim of improved compliance while maintaining a reduced readmission rate that was observed with the original quality improvement study. Method A single-centre, cross-sectional study for assessing baseline data and a prospective observational study to assess the effectiveness of a refined readmission prevention checklist tool in a 20-bed tertiary medical-surgical intensive care unit at an academic medical centre in Rochester, MN was conducted. Medical patients admitted through the emergency department, upon direct transfer from outside facility, and post-operative surgical patients at our institution were included. A refined readmission prevention checklist tool was administered during an 8-week pilot period for medical and post-operative surgical patients. Results The refined readmission prevention checklist resulted in an even lower compliance (10.5%) from the initial phase likely resulting from utilization of a paper readmission prevention checklist in an electronic medical environment. Moreover, the refined readmission prevention checklist demonstrated a 22% unplanned readmission rate for patients in which the tool was utilized. Conclusions In conclusion, the findings of the current quality improvement study may serve to rethink the process of health care delivery that applies paper tools in an electronic medical environment.

Original languageEnglish (US)
Pages (from-to)348-351
Number of pages4
JournalJournal of Evaluation in Clinical Practice
Volume20
Issue number4
DOIs
StatePublished - Aug 2014

Fingerprint

Checklist
Intensive Care Units
Quality Improvement
Medical Electronics
Compliance
Patient Readmission
Critical Care
Observational Studies
Hospital Emergency Service
Patient Care
Cross-Sectional Studies
Prospective Studies
Delivery of Health Care
Costs and Cost Analysis

Keywords

  • dismissal checklist
  • electronic
  • intensive care unit
  • paper
  • quality improvement
  • refined
  • unplanned readmission

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Intensive care unit readmission prevention checklist : Is it worth the effort? / Smischney, Nathan J.; Cawcutt, Kelly A.; O'Horo, John C.; Sevilla Berrios, Ronaldo A.; Whalen, Francis X.

In: Journal of Evaluation in Clinical Practice, Vol. 20, No. 4, 08.2014, p. 348-351.

Research output: Contribution to journalArticle

Smischney, Nathan J. ; Cawcutt, Kelly A. ; O'Horo, John C. ; Sevilla Berrios, Ronaldo A. ; Whalen, Francis X. / Intensive care unit readmission prevention checklist : Is it worth the effort?. In: Journal of Evaluation in Clinical Practice. 2014 ; Vol. 20, No. 4. pp. 348-351.
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abstract = "Rationale, aims and objectives Checklists have been adopted by various institutions to improve patient outcomes. In particular, readmission prevention checklists may be of potential value to improve patient care and reduce medical costs. As a result, a prior quality improvement study was conducted to create an intensive care unit readmission prevention checklist. The previous pilot demonstrated zero readmissions when the readmission prevention checklist was utilized but yielded low compliance (30{\%}). Thus, a subsequent quality initiative was undertaken to refine the readmission prevention checklist with the primary aim of improved compliance while maintaining a reduced readmission rate that was observed with the original quality improvement study. Method A single-centre, cross-sectional study for assessing baseline data and a prospective observational study to assess the effectiveness of a refined readmission prevention checklist tool in a 20-bed tertiary medical-surgical intensive care unit at an academic medical centre in Rochester, MN was conducted. Medical patients admitted through the emergency department, upon direct transfer from outside facility, and post-operative surgical patients at our institution were included. A refined readmission prevention checklist tool was administered during an 8-week pilot period for medical and post-operative surgical patients. Results The refined readmission prevention checklist resulted in an even lower compliance (10.5{\%}) from the initial phase likely resulting from utilization of a paper readmission prevention checklist in an electronic medical environment. Moreover, the refined readmission prevention checklist demonstrated a 22{\%} unplanned readmission rate for patients in which the tool was utilized. Conclusions In conclusion, the findings of the current quality improvement study may serve to rethink the process of health care delivery that applies paper tools in an electronic medical environment.",
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