Hospital readmissions: physician awareness and communication practices.
BACKGROUND
Patients requiring early hospital readmission may be readmitted to different physicians, potentially without the knowledge of the prior caregivers. This lost opportunity to share information about readmitted patients may be detrimental to quality of care and resident education.


OBJECTIVE
To measure physician awareness of and communication about readmissions.


METHODS
Cross-sectional study.


METHODS
Two academic medical centers.


METHODS
A total of 432 patients discharged from the general medicine services and readmitted within 14 days.


METHODS
We identified patients discharged from the general medicine services and readmitted within 14 days, excluding patients readmitted to the same physician(s) and planned readmissions. We surveyed discharging and readmitting physicians 48 h after the time of readmission.


RESULTS
Discharging physician teams were aware of 48.5% (95% CI 41.5%-55.5%) of patient readmissions. Communication between teams occurred on 43.7% (95% CI 37.1%-50.3%). Higher medical complexity was associated with an increased likelihood of physician communication (adjusted OR 1.12, 95% CI 1.06-1.19). When communication occurred, readmitting physicians received information about the discharging team's overall assessment (61.9%, 95% CI 51.9%-71.9%), psychosocial issues (52.6%, 95% CI 42.4%-62.8%), pending tests (34.0%, 95% CI 24.2%-43.8%), and discharge medications (30.9%, 95% CI 21.5%-40.3%). When communication did not occur, most physicians (60.8%, 95% CI 56.7%-64.9%) responded it would have been desirable to communicate.


CONCLUSIONS
Physicians are frequently unaware of patient readmissions and often do not communicate when readmissions occur. This communication is often desired and frequently results in the exchange of important patient information. Further work is needed to design systems to address this potential discontinuity of care.
Roy
Christopher L
CL
Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA. croy@partners.org
Kachalia
Allen
A
Woolf
Seth
S
Burdick
Elisabeth
E
Karson
Andrew
A
Gandhi
Tejal K
TK
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010359:Patient Readmission