Minimizing Unplanned Returns
In a perfect world, Emory would have a no unplanned return policy for our patients. That is, we strive to avoid any unplanned readmissions to our hospitals after a previous hospital stay. An example would be a patient who is readmitted to the hospital for a wound infection related to a surgical procedure following an initial hospital stay. There are a number of situations that can lead to patient readmissions. Some are not preventable and not all readmissions are related to a previous visit.
Readmission rate is the proportion of patients who return to the hospital within 30 days. Chemotherapy, radiation therapy, dialysis, rehabilitation, psychiatric (within 1 day) cases are excluded from the calculation as such readmissions are often planned (i.e. intentional). Hospice, Obstetric patients, Nonviable neonatal, Neonatology, and newborns are also excluded from the readmissions calculation. Otherwise, due to limitations of the data, planned readmissions are not excluded unless they fall within one of these excluded product lines.
In the case of hospital readmission rates, generally, the lower the percentage, the better. A lower score means that we were able to successfully treat patients the first time and that we have discharged patients safely and effectively. It also means that following recommended care instructions helps to keep patients from being readmitted after hospitalization, including follow-up appointments, medications, and other appropriate actions. As an academic medical center, the nature of illnesses that Emory patients have is such that our patients are more likely to have relapses necessitating readmission. This measure also includes readmissions for problems that are unrelated to the previous admission. Because of this and because relapses are not entirely preventable and because, as noted above, planned readmissions are not entirely excluded, a readmission rate of zero is not attainable. Emory’s ongoing quality improvement efforts include several programs to ensure that when our patients are discharged, they have a clear understanding of what they need to do, how to get medical help if needed and when to see their physicians in follow up.