Development of a real-time general medicine 30-day readmissions notification system

Hospital readmissions present a costly problem for healthcare systems. Engaging care providers in reviewing readmissions may reveal opportunities for reducing readmissions and improving quality. We developed a real-time alerting method that e-mails providers when a discharged patient returns for care (emergency department [ED] or hospital admission) within 30 days. We analyzed the content of alerts to consider frequency of presentation and demographic characteristics of readmitted patients. From 3/15/2011 to 8/31/2011, 1544 alerts (943 ED returns; 601 inpatient readmissions) were generated, representing 621 unique patients (average return time: 12.8±8.5 days). Forty-eight faculty received alerts; 88.8% of alerts were sent to the correct discharging provider. Real-time alerting allows providers to re-engage with readmitted patients and offers a means for evaluating performance. Such systems may also elucidate reasons for readmission by detailing practice patterns and populations at risk for readmission as well as help to design targeted interventions to reduce hospital returns.