Implementation of a quality-improvement project to improve identification of patients at high risk for psychiatric hospitalization

Abstract

Readmission to a psychiatric hospital within 30 days is a common problem. Worldwide, nearly one in seven individuals hospitalized for psychiatric reasons are readmitted within 30 days of discharge. Frequent readmissions in individuals with a psychiatric cause are also problematic in the Western United States. The aim of this DNP project was to use the READMIT tool to determine if it can predict psychiatric readmission within 30 days of hospital discharge. The cohort included in the project were adults 18-years-old and older diagnosed as having a psychiatric disorder that caused them to be admitted to an inpatient psychiatric treatment unit. Data were collected from a 'healthcare organization in a western state' using a retrospective chart review of 50 electronic medical records (EMRs) that were at least one year old. The data were collected on the retrospective dates of 06/24/17, 7/01/17, and 7/08/17. The dates were selected close together so that treatments, providers, and cares would be relatively similar, thus having less of a chance to skew the data. Each of the 50 patient charts was examined and each was given its own separate score generated by the READMIT tool. The READMIT tool's scores ranged from 0 to 41, with higher scores indicating an increased probability for readmission. The mean READMIT score for patients that were readmitted was 23.21 compared with a mean of 17.78 for the group of patients that were not readmitted. Of the charts examined for this study, 14 (28%) of them were readmitted within 30 days. The READMIT index did show that the higher an individual scores, the more likely he or she would be readmitted. The READMIT tool has the potential to enhance psychiatric treatment as it can identify individuals more likely to be readmitted.