title: The use of an automated notification system to identify and address early readmissions by a university hospitalist service.
abstract: OBJECTIVE
  To examine the association of an automated physician feedback system prompting physician review of early readmissions with a change in overall readmission rates.
  
  
  METHODS
  The University of Utah Internal Medicine Hospitalist Service created an automated system to alert discharging providers to any patient readmitted within 30 days. For any 7-day readmission, the physician was asked to complete a survey to describe the admission and discharge and to identify contributing factors to the readmission. Using the University HealthSystem Consortium database, readmission rates were compared prior to and following this intervention.
  
  
  RESULTS
  Following the intervention, 30-day readmission rates significantly decreased from 13.93% to 11.99% (p = 0.0298). The 7-day readmission rates decreased as well but the findings were not statistically significant. The discharging physician deemed 45% of the readmissions preventable or probably preventable.
  
  
  CONCLUSIONS
  Readmissions are common, costly and potentially preventable. This tool for physician audit and feedback and identification of defects contributing to readmissions was associated with a statistically significant decrease in 30-day readmissions. Further investigation is needed to verify these results and evaluate the best mechanism of application.
authors.affiliation: Department of Internal Medicine, University of Utah Medical Center , Salt Lake City, UT 84132 , USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Bell
authors.forename: Jeff
authors.initials: J
authors.lastname: Povilus
authors.forename: Peter M
authors.initials: PM
authors.lastname: Yarbrough
mesh_terms: D001291:Attitude of Health Personnel; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000458:organization & administration*; D005500:Follow-Up Studies; D006747:Hospital Communication Systems / Q000706:statistics & numerical data*; D006801:Humans; D008505:Medical Staff, Hospital / Q000458:organization & administration; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D058996:Quality Improvement; D014589:Utah
keywords: Audit; automated; discharge; feedback; hospitalists; readmissions