title: The perspectives of patients, family members and healthcare professionals on readmissions: preventable or inevitable?
abstract: An understanding of what complex medical patients with chronic conditions, family members and healthcare professionals perceive to be the key reasons for the readmission is important to preventing their occurrence. In this context, we undertook a study to understand the perceptions of patients, family members and healthcare professionals regarding the reasons for, and preventability of, readmissions. An exploratory case design with semi-structured interviews was conducted with 49 participants, including patients, family members, nurses, case managers, physicians, discharge planners from a general internal medicine unit at a large and academic hospital. Data were analyzed using a directed content analysis approach that involved three investigators. Two contrasting themes emerged from the analysis of interview data set. The first theme was readmissions as preventable occurrences. Our analyses elucidated contributing factors to readmissions during the patients' hospital stay and after the patients were discharged. The second theme was readmissions as inevitable, occurring due to the progression of disease. Our study findings indicate that some readmissions are perceived to be inevitable due to the burden of disease while others are perceived to be preventable and associated with factors both in hospital and post-discharge. Continued interprofessional efforts are required to identify patients at risk for readmission and to organize and deliver care to improve health outcomes after hospitalization.
authors.affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario , Canada and.
authors.forename: Lianne
authors.initials: L
authors.lastname: Jeffs
authors.forename: Irfan
authors.initials: I
authors.lastname: Dhalla
authors.forename: Roberta
authors.initials: R
authors.lastname: Cardoso
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D002170:Canada; D018450:Disease Progression; D005190:Family / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007388:Internal Medicine; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D010361:Patients / Q000523:psychology*; D058996:Quality Improvement; D011787:Quality of Health Care; D012307:Risk Factors
keywords: Content analysis; interprofessional care; interprofessional practice