A Multidisciplinary Approach to Reducing Hospital Readmission Rates: Perspectives of Different Healthcare Providers

Main Article Content

Fahad Obaid Alotaibi¹, Abdullah Obaid Al-Otaibi², Salman Awad Omar Al-Otaibi³, Munahi Mazyad Munahi Alotaibi⁴, Faisal Trihib Alotebe⁵, Yasser Khalid Alotaibi⁶, Abdullah Salman Alruqi⁷, Nabilah Ahmad Mohammed Asheri⁸, Abdulrahman Saad Mohammed Alabdulkarim⁹

Keywords

hospital readmissions, multidisciplinary approach, care transitions, patient education, medication reconciliation, social support

Abstract

Hospital readmissions pose a significant challenge to healthcare systems worldwide, leading to increased healthcare costs, resource utilization, and patient morbidity. Reducing readmission rates requires a coordinated, multidisciplinary approach involving various healthcare professionals. This article presents the perspectives of pharmacists, nurses, radiologists, social workers, public health professionals, and laboratory specialists on strategies to reduce hospital readmissions. By leveraging the unique expertise and contributions of each discipline, healthcare organizations can develop comprehensive interventions to improve care transitions, patient education, medication management, social support, and post-discharge follow-up. Key strategies include medication reconciliation, patient and caregiver education, discharge planning, social needs assessment, early outpatient follow-up, and the use of predictive models to identify high-risk patients. Effective communication and collaboration among the multidisciplinary team are essential for successful implementation. By adopting a multidisciplinary approach, healthcare systems can reduce readmission rates, improve patient outcomes, and enhance the overall quality of care

Abstract 117 | PDF Downloads 29

References

Alper, E., O'Malley, T. A., & Greenwald, J. (2017). Hospital discharge and readmission. UpToDate.
Altfeld, S. J., Shier, G. E., Rooney, M., Johnson, T. J., Golden, R. L., Karavolos, K., Avery, E., Nandi, V., & Perry, A. J. (2013). Effects of an enhanced discharge planning intervention for hospitalized older adults: a randomized trial. The Gerontologist, 53(3), 430-440.
Baird, G. (2014). The laboratory test utilization management toolbox. Biochemia Medica, 24(2), 223-234.
Bergh, A. L., Karlsson, J., Persson, E., & Friberg, F. (2012). Registered nurses' perceptions of conditions for patient education - focusing on organisational, environmental and professional cooperation aspects. Journal of Nursing Management, 23(6), 758-770.
Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic Medicine, 93(9), 1271-1275.
Bronstein, L. R., Gould, P., Berkowitz, S. A., James, G. D., & Marks, K. (2015). Impact of a social work care coordination intervention on hospital readmission: a randomized controlled trial. Social Work, 60(3), 248-255.
Bruno, M. A., Walker, E. A., & Abujudeh, H. H. (2015). Understanding and confronting our mistakes: the epidemiology of error in radiology and strategies for error reduction. Radiographics, 35(6), 1668-1676.
Calvillo-King, L., Arnold, D., Eubank, K. J., Lo, M., Yunyongying, P., Stieglitz, H., & Halm, E. A. (2013). Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. Journal of General Internal Medicine, 28(2), 269-282.
Choudhry, S. A., Li, J., Davis, D., Erdmann, C., Sikka, R., & Sutariya, B. (2013). A public-private partnership develops and externally validates a 30-day hospital readmission risk prediction model. Online Journal of Public Health Informatics, 5(2), 219.
Dasgupta, A. (2012). Therapeutic drug monitoring: newer drugs and biomarkers. Academic Press.
Durand, D. J., Lewin, J. S., & Berkowitz, S. A. (2015). Medical-imaging stewardship in the accountable care era. New England Journal of Medicine, 373(18), 1691-1693.
Epner, P. L., Gans, J. E., & Graber, M. L. (2013). When diagnostic testing leads to harm: a new outcomes-based approach for laboratory medicine. BMJ Quality & Safety, 22(Suppl 2), ii6-ii10.
Findley, P. A. (2014). Social work practice in the chronic care model: chronic illness and disability care. Journal of Social Work, 15(4), 409-427.
Hospital Readmissions Reduction Program (HRRP). (2020). Centers for Medicare & Medicaid Services.
Jackson, C., Shahsahebi, M., Wedlake, T., & DuBard, C. A. (2015). Timeliness of outpatient follow-up: an evidence-based approach for planning after hospital discharge. The Annals of Family Medicine, 13(2), 115-122.
Kripalani, S., Theobald, C. N., Anctil, B., & Vasilevskis, E. E. (2014). Reducing hospital readmission: current strategies and future directions. Annual Review of Medicine, 65, 471-485.
Larson, D. B., Froehle, C. M., Johnson, N. D., Towbin, A. J., Pryor, R. M., & Donnelly, L. F. (2014). Communication in diagnostic radiology: meeting the challenges of complexity. American Journal of Roentgenology, 203(5), 957-964.
Mackert, M., Mabry-Flynn, A., Champlin, S., Donovan, E. E., & Pounders, K. (2016). Health literacy and health information technology adoption: the potential for a new digital divide. Journal of Medical Internet Research, 18(10), e264.
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015). Hospital readmissions reduction program. Circulation, 131(20), 1796-1803.
Mueller, S. K., Sponsler, K., Kripalani, S., & Schnipper, J. L. (2012). Hospital-based medication reconciliation practices: a systematic review. Archives of Internal Medicine, 172(14), 1057-1069.
Pellett, C. (2016). Discharge planning: best practice in transitions of care. British Journal of Community Nursing, 21(11), 542-548.
Roy, C. L., Rothschild, J. M., Dighe, A. S., Schiff, G. D., Graydon -Baker, E., Lenoci-Edwards, J., Dwyer, C., Khorasani, R., & Gandhi, T. K. (2013). An initiative to improve the management of clinically significant test results in a large health care network. The Joint Commission Journal on Quality and Patient Safety, 39(11), 517-517.
Viswanathan, M., Kahwati, L. C., Golin, C. E., Blalock, S. J., Coker-Schwimmer, E., Posey, R., & Lohr, K. N. (2015). Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Internal Medicine, 175(1), 76-87.
Zuckerman, R. B., Sheingold, S. H., Orav, E. J., Ruhter, J., & Epstein, A. M. (2016). Readmissions, observation, and the Hospital Readmissions Reduction Program. New England Journal of Medicine, 374(16), 1543-1551.