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Avoidable 30‐day readmissions in patients undergoing vascular surgery

BACKGROUND: Vascular surgery has one of the highest unplanned 30‐day readmission rates of all surgical specialties. The degree to which these may be avoidable and the optimal strategies to reduce their occurrence are unknown. The aim of this study was to identify and classify avoidable 30‐day readmi...

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Autores principales: Knighton, A., Martin, G., Sounderajah, V., Warren, L., Markiewicz, O., Riga, C., Bicknell, C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887707/
https://www.ncbi.nlm.nih.gov/pubmed/31832582
http://dx.doi.org/10.1002/bjs5.50191
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author Knighton, A.
Martin, G.
Sounderajah, V.
Warren, L.
Markiewicz, O.
Riga, C.
Bicknell, C.
author_facet Knighton, A.
Martin, G.
Sounderajah, V.
Warren, L.
Markiewicz, O.
Riga, C.
Bicknell, C.
author_sort Knighton, A.
collection PubMed
description BACKGROUND: Vascular surgery has one of the highest unplanned 30‐day readmission rates of all surgical specialties. The degree to which these may be avoidable and the optimal strategies to reduce their occurrence are unknown. The aim of this study was to identify and classify avoidable 30‐day readmissions in patients undergoing vascular surgery in order to plan targeted interventions to reduce their occurrence, improve outcomes and reduce cost. METHODS: A retrospective analysis of discharges over a 12‐month period from a single tertiary vascular unit was performed. A multidisciplinary panel conducted a manual case‐note review to identify and classify those 30‐day unplanned emergency readmissions deemed avoidable. RESULTS: An unplanned 30‐day readmission occurred in 72 of 885 admissions (8·1 per cent). These unplanned readmissions were deemed avoidable in 36 (50 per cent) of these 72 patients, and were most frequently due to unresolved medical issues (19 of 36, 53 per cent) and inappropriate admission with the potential for outpatient management (7 of 36, 19 per cent). A smaller number were due to inadequate social care provision (4 of 36, 11 per cent) and the occurrence of other avoidable adverse events (4 of 36, 11 per cent). CONCLUSION: Half of all 30‐day readmissions following vascular surgery are potentially avoidable. Multidisciplinary coordination of inpatient care and the transition from hospital to community care after discharge need to be improved.
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spelling pubmed-68877072019-12-12 Avoidable 30‐day readmissions in patients undergoing vascular surgery Knighton, A. Martin, G. Sounderajah, V. Warren, L. Markiewicz, O. Riga, C. Bicknell, C. BJS Open Original Articles BACKGROUND: Vascular surgery has one of the highest unplanned 30‐day readmission rates of all surgical specialties. The degree to which these may be avoidable and the optimal strategies to reduce their occurrence are unknown. The aim of this study was to identify and classify avoidable 30‐day readmissions in patients undergoing vascular surgery in order to plan targeted interventions to reduce their occurrence, improve outcomes and reduce cost. METHODS: A retrospective analysis of discharges over a 12‐month period from a single tertiary vascular unit was performed. A multidisciplinary panel conducted a manual case‐note review to identify and classify those 30‐day unplanned emergency readmissions deemed avoidable. RESULTS: An unplanned 30‐day readmission occurred in 72 of 885 admissions (8·1 per cent). These unplanned readmissions were deemed avoidable in 36 (50 per cent) of these 72 patients, and were most frequently due to unresolved medical issues (19 of 36, 53 per cent) and inappropriate admission with the potential for outpatient management (7 of 36, 19 per cent). A smaller number were due to inadequate social care provision (4 of 36, 11 per cent) and the occurrence of other avoidable adverse events (4 of 36, 11 per cent). CONCLUSION: Half of all 30‐day readmissions following vascular surgery are potentially avoidable. Multidisciplinary coordination of inpatient care and the transition from hospital to community care after discharge need to be improved. John Wiley & Sons, Ltd 2019-08-02 /pmc/articles/PMC6887707/ /pubmed/31832582 http://dx.doi.org/10.1002/bjs5.50191 Text en © 2019 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Knighton, A.
Martin, G.
Sounderajah, V.
Warren, L.
Markiewicz, O.
Riga, C.
Bicknell, C.
Avoidable 30‐day readmissions in patients undergoing vascular surgery
title Avoidable 30‐day readmissions in patients undergoing vascular surgery
title_full Avoidable 30‐day readmissions in patients undergoing vascular surgery
title_fullStr Avoidable 30‐day readmissions in patients undergoing vascular surgery
title_full_unstemmed Avoidable 30‐day readmissions in patients undergoing vascular surgery
title_short Avoidable 30‐day readmissions in patients undergoing vascular surgery
title_sort avoidable 30‐day readmissions in patients undergoing vascular surgery
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887707/
https://www.ncbi.nlm.nih.gov/pubmed/31832582
http://dx.doi.org/10.1002/bjs5.50191
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