Readmission risk identification: Implementation of a patient-centered interview.

Abstract

6564 Background: Unplanned 30-day readmissions in the cancer population are common. There are few large studies describing cancer patients’ readmission perspective. To better define predisposing factors associated with readmission, our Nurse Case Manager team implemented a patient-focused survey. Methods: Cancer patients readmitted to The James Cancer Hospital from May 2020-December 2021 were included. Readmission events were defined as an inpatient hospital readmission within 30 days of the patient’s prior hospitalization. Team members conducted a 16-question survey immediately following readmission to evaluate the patients’ perspective on factors that may have contributed to their readmission; results were recorded. Results: A total of 3,333 readmissions were unplanned, 109 planned, 22 listed as other; 3,464 patients completed interviews (Table). During their index admission, most patients reported receiving (90%) and understanding (89%) discharge education/instructions. Upon index discharge, most patients (62%) were discharged on a new medication; the majority reported filling their prescription (95%) and taking it as instructed (98%). Nearly all patients had a post-index hospitalization follow up appointment scheduled, but only 58% reported attending. The primary reason reported for not attending was readmission prior to the appointment. Just over 50% of patients received a post-index hospital stay phone call. Some patients (6% yes; 58% unanswered) felt services at discharge would have been helpful. Most patients (51%) contacted their provider regarding worrisome symptoms experienced prior to being readmitted. Pain (18%), fever (11%), and shortness of breath (10%) were the most commonly reported symptoms that prompted returning to the hospital. Conclusions: To our knowledge, this is the largest study to date of cancer patients’ own perspective of their 30-day readmission. More immediate post-hospitalization follow up and increased deployment of tailored discharge services represent areas of opportunity identified to decrease readmission rates. Symptom-specific interventions may also be impactful. Due to the negative downstream effects readmissions have on the healthcare system, it is critical to develop risk mitigation strategies incorporating patient-reported experience. [Table: see text]