Readmission Rate to ICU
Number of ICU readmission within 72 hours per 100 discharges to 1) ward only and 2) ward, home or elsewhere.
| Indicators | |
| Indicator: | Readmission Rate to ICU |
| Created/Raw: | created |
| Program: | Critical Care |
| Start Date: | |
| End Date: | |
| Reports: | Critical Care Program Quality Indicator Report, HSC ICUs Data by Patient |
| Data Dependencies(Reports/Indicators/Data Elements): | Palliative care • Palliative Service • Palliative patient • Comfort Care • AMA • Admit Type for APACHE II • Dispo • Dispo DtTm • Admit date and time • Person ID field |
Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital.
QI domain
- Safe
Reported as
- Definition1 : Percent of total discharges to ward
- Definition2 : Percent of total discharges to ward, home and elsewhere
Significance
Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.
Sampling Plan / Procedure
Inclusion Criteria
We report these in two ways:
- Definition1: 100% of all ICU patients discharged to ward
- Definition2: 100% of all ICU patients discharged to ward, home or elsewhere
Exclusion Criteria
- Definition1 & 2 : Excluding patients with planned and scheduled surgery in the count of readmission.
- Definition2 : Excluding patients who left AMA or palliative patients in the count of readmission.
- Elective surgery
- Admit Type for APACHE II is 'Elect.Surg'
- Palliative patients: The coding changed over time, see index page for adjacent concepts:
- starting Jan 1, 2019 - ICD10 dx Palliative care (Z51.5)
- Nov 11, 2013 to Aug 26, 2019 - use Tmp Project Comfort Care
- Beginning to Nov 2013 - use the Pre-ICD10 Diagnosis Code List code 90400 Palliative Service
- Before Nov 11, 2013 "90400 - "Palliative Care" used to be applied as a code if a patient was either comfort care, ACP-C, palliation, end of life care or consulted to palliative care service.
- AMA - see AMA
Frequency
Monthly, quarterly or yearly based on either admission dates or discharge dates
Definition and Derivation
Readmission means the patient left/discharged out of ICU to elsewhere and came back to ICU in the same or different facility from elsewhere. Readmission count is accounted to the unit discharging the patient the first time and not to the unit admitting the patient the second time.
- Definition1 : Number of ICU readmission within 72 hours per 100 discharges to any ward
- Definition2 : Number of ICU readmission within 72 hours per 100 discharges to any ward, home or elsewhere
Numerator
- Num1 = Number of ICU patients discharged to any ward and readmitted to any ICU within 72 hours coming from elsewhere
- Num2 = Number of ICU patients discharged to any ward, home or elsewhere and readmitted to any ICU within 72 hours coming from elsewhere
Denominator
- Denom1 =Total Number of discharges who went to any ward
- Denom2 =Total Number of discharges who went to any ward, home or elsewhere
Formula
Readmission Rate(%) = Num / Denom * 100
Example
- Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
- Total readmission within 72 hours of patients previously discharged to any ward= 5
- Total discharges who went to ward = 102
- Readmission Rate(%) = 5 / 102 * 100= 4.9 %
Data Sources
See infobox in top left
SAS Program
S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas
Report Users
- Critical Care Directors and Site Managers
- Critical Care Quality Improvement Team (QIT)
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