Readmission to MedWard: Difference between revisions
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==QI domain== | ==QI domain== | ||
* Safe | * [[QualityDomain::Safe]] | ||
==Reported as== | ==Reported as== | ||
Percent of total discharges to hospital | * Percent of total discharges to hospital (Rate) | ||
* List of individual patients for chart review | |||
==Significance== | ==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 ward occupancy at the time of discharge. Readmission may reflect premature transfer out of hospital due to errors in clinical judgment or system constraints. | 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 ward occupancy at the time of discharge. Readmission may reflect premature transfer out of hospital due to errors in clinical judgment or system constraints. | ||
==Sampling Plan / Procedure== | ==Sampling Plan / Procedure== | ||
===Inclusion Criteria=== | ===Inclusion Criteria=== | ||
100% of all | 100% of all patients discharged from medicine ward to home/PCH, outside Winnipeg/Manitoba/Canada hospitals/facilities. | ||
===Exclusion Criteria=== | ===Exclusion Criteria=== | ||
Excluding patients who left against medical advice (AMA), palliative patients in the count of readmission. | Excluding patients who left against medical advice ([[AMA]]), [[Palliative Service|palliative patients]] in the count of readmission. | ||
Exclusions for readmissions are the following: | |||
* There is a planned admission like elective surgery | |||
* Left the ward or unit against medical advice ([[Dispo]] = [[AMA]]) | |||
* Palliative patients at admission | |||
** The coding for Palliative changed over time. | |||
*** Until Dec 31, 2018 Old coding - 904 and Tmp Project [[Comfort Care]] | |||
*** starting Jan 1, 2019 - ICD10 dx [[Palliative care]] (Z51.5) | |||
* HSC IICU has no readmission | |||
===Frequency=== | ===Frequency=== | ||
==Definition and Derivation== | ==Definition and Derivation== | ||
For medicine, a readmission is a patient where | |||
* (current [[Admit DtTm | admit date/time]]) - (most recent [[Dispo DtTm | discharge date/time]] to the hospital) is within 7 days after their most recent discharge date time to the hospital | |||
* is admitted from outside hospital | |||
===Numerator=== | ===Numerator=== | ||
Num = Number of ward | Num = Number of ward readmission within 7 days after being discharged out | ||
===Denominator=== | ===Denominator=== | ||
Denom =Total Number of discharges who left the hospital (e.g. went home/nursing home, outside city, province or country) | Denom =Total Number of discharges who left the hospital (e.g. went home/nursing home, outside city, province or country) | ||
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==Data Sources== | ==Data Sources== | ||
The following fields | The following fields: | ||
[[Admit DtTm]], [[Dispo DtTm field]], [[Dispo field]], the Project [[Comfort Care]] from L_TmpV2 table and diagnosis code [[Palliative Service]] from L_DXs table, ICD10 code Z51.5 [[Palliative care]] from L_ICD10 table are used. Julie has confirmed this setup 2022 April 21. | |||
==SAS Program== | ==SAS Program== | ||
| Line 45: | Line 62: | ||
==Report Users== | ==Report Users== | ||
Medicine Directors and Site Managers | *Medicine Directors and Site Managers | ||
Medicine Standards Committee - Dr. Elizabeth Salamon | *Medicine Standards Committee - Dr. Elizabeth Salamon | ||
[[Category: Data Use]] | [[Category: Data Use]] | ||
[[Category: Reporting]] | [[Category: Reporting]] | ||
[[Category: Statistical Analysis]] | [[Category: Statistical Analysis]] | ||
[[Category:Multiple Encounter linking]] | [[Category: Multiple Encounter linking]] | ||
Latest revision as of 15:19, 2022 April 28
Number of Ward readmission within 7 days per 100 discharges to hospital.
| Indicators | |
| Indicator: | Readmission Rate to Med ward |
| Created/Raw: | Created |
| Program: | Medicine |
| Start Date: | |
| End Date: | |
| Reports: | Directors Quarterly and Annual Report (Medicine), Mortality and readmission report |
QI domain
- Safe
Reported as
- Percent of total discharges to hospital (Rate)
- List of individual patients for chart review
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 ward occupancy at the time of discharge. Readmission may reflect premature transfer out of hospital due to errors in clinical judgment or system constraints.
Sampling Plan / Procedure
Inclusion Criteria
100% of all patients discharged from medicine ward to home/PCH, outside Winnipeg/Manitoba/Canada hospitals/facilities.
Exclusion Criteria
Excluding patients who left against medical advice (AMA), palliative patients in the count of readmission.
Exclusions for readmissions are the following:
- There is a planned admission like elective surgery
- Left the ward or unit against medical advice (Dispo = AMA)
- Palliative patients at admission
- The coding for Palliative changed over time.
- Until Dec 31, 2018 Old coding - 904 and Tmp Project Comfort Care
- starting Jan 1, 2019 - ICD10 dx Palliative care (Z51.5)
- The coding for Palliative changed over time.
- HSC IICU has no readmission
Frequency
Definition and Derivation
For medicine, a readmission is a patient where
- (current admit date/time) - (most recent discharge date/time to the hospital) is within 7 days after their most recent discharge date time to the hospital
- is admitted from outside hospital
Numerator
Num = Number of ward readmission within 7 days after being discharged out
Denominator
Denom =Total Number of discharges who left the hospital (e.g. went home/nursing home, outside city, province or country)
Formula
Readmission Rate(%) = Num / Denom * 100
Example
- Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
- Total readmission within 7 days after discharge to hospital= 5
- Total discharges who left the hospital= 102
- Readmission Rate(%) = 5 / 102 * 100= 4.9 %
Data Sources
The following fields: Admit DtTm, Dispo DtTm field, Dispo field, the Project Comfort Care from L_TmpV2 table and diagnosis code Palliative Service from L_DXs table, ICD10 code Z51.5 Palliative care from L_ICD10 table are used. Julie has confirmed this setup 2022 April 21.
SAS Program
X:\Julie\SAS_CFE\CFE_macros\medreadm.sas
Report Users
- Medicine Directors and Site Managers
- Medicine Standards Committee - Dr. Elizabeth Salamon