Patients identify factors that contribute to readmissions after surgery

Despite concerns about the validity of postoperative readmission rates as a quality metric, these rates are now publicly reported, and hospitals with higher than benchmark rates are penalized by the Centers for Medicare & Medicaid.

In the past, predictors of readmission have been investigated primarily with large databases that lack the patient’s perspective, which makes prediction tools imprecise.

The objective of this study from the University of Wisconsin, Madison, was to use a human factors and systems engineering approach to examine contributors to readmission after complex surgical procedures.

Factors identified by patients and clinician providers that may have contributed to readmission included:

• poor patient and caregiver understanding
• inadequate discharge preparation
• insufficient educational process and materials
• inadequate care team communication.

This is the first study to use a human factors and systems engineering approach to evaluate the impact of the quality of the transition of care and its influence on readmission from the patient and clinician perspective, the researchers note.

—Acher A W, LeCaire T J, Hundt A S, et al. Using human factors and systems engineering to evaluate readmission after complex surgery. J Am Coll Surg. 2015;221(4):810-820.

http://www.journalacs.org/article/S1072-7515(15)00432-9/abstract