title: Reducing Hospital Readmissions via Optimization of Emergency Department Care.
abstract: Over the past 5 years, early hospital readmissions have become a national focus. With several recent publications highlighting the high rates of early hospital readmissions among transplant recipients, more work is needed to identify risk factors and strategies for reducing unnecessary readmissions among this patient population. Although the American Society of Transplant Surgeons is advocating the exclusion of transplant recipients from the calculation of hospital readmission rates, the outcome of their advocacy efforts remains uncertain. One potential strategy for reducing early hospital readmissions is to critically examine care received by transplant recipients in the emergency department (ED), a critical pathway to readmission. As a starting point, research is needed to assess rates of ED presentation among transplant recipients, diagnostic algorithms, and communication among clinical teams. Mixed-methods studies that enhance understanding of system-level barriers to optimized evaluation and treatment of transplant recipients in the ED may lead to quality improvement interventions that reduce unnecessary readmissions, even if the rates of transplant recipients presenting to the ED remains high.
authors.affiliation: 1 Northwestern University Transplant Outcomes Research Collaborative, Northwestern University Feinberg School of Medicine, Chicago, IL. 2 Center for Health Care Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 3 Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: McElroy
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Schmidt
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Richards
authors.forename: Megan C
authors.initials: MC
authors.lastname: McHugh
authors.forename: Jane L
authors.initials: JL
authors.lastname: Holl
authors.forename: James G
authors.initials: JG
authors.lastname: Adams
authors.forename: Daniela P
authors.initials: DP
authors.lastname: Ladner
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D019091:Critical Pathways; D004636:Emergency Service, Hospital / Q000191:economics / Q000639:trends; D017048:Health Care Costs; D006801:Humans; D016377:Organ Transplantation / Q000009:adverse effects*; D010359:Patient Readmission / Q000191:economics / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors