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Publication Date

11-20-2015

Keywords

pancreatitis, hospital readmission, risk factors, quality improvement

Abstract

Background: Early hospital readmissions are a direct burden on both our patients’ well-being and health care system as a whole. Acute pancreatitis is a top offender, with countless 30-day readmissions. Studies have showed a consistently higher than average 30-day readmission rates in acute pancreatitis, around 19%. This is significantly higher than the average all-cause readmission rate at Aurora Health Care hospitals. This quality improvement project aimed to reduce the rate of acute pancreatitis 30-day readmission rates at several Aurora hospitals through patient education and a readmission risk assessment tool.

Purpose: To clarify some of the risk factors associated with acute pancreatitis readmissions and reduce 30-day acute pancreatitis readmission rates through patient education and risk assessment to facilitate a safe discharge.

Methods: Project was conducted out of Aurora’s Sinai, St. Luke’s and West Allis Medical Centers with a total of 18 patients with acute pancreatitis admitted predominantly to the internal medicine teaching service between February 2014 and October 2014. Patients were seen within 1–2 days of admission and provided one-on-one education with a handout on acute pancreatitis. In addition, a 30-day pancreatitis readmission predictor (PRP) score was used to classify patient as low (5%), moderate (17%) or high (68%) risk for readmission via Epic health record’s “Dot Phrase.” Subsequent readmissions, 14-day follow-up, total hospitalizations and emergency department visits were tracked through present. This was compared to readmission rates of a randomly selected control group of 18 patients admitted with acute pancreatitis.

Results: Patients had PRP scores ranging from 0 to 4, with an average of 1 (rounded from 0.78). Of the 18 patients in the study group, only 2 were readmitted within 30 days for pancreatitis, or 11.1%. The control group had 3 (16.7%) readmissions within 30 days. Patients with alcohol-related pancreatitis were more likely to have a higher PRP (1.0) and readmission rate (20%, 2/10).

Conclusion: A diagnosis of acute pancreatitis places the patient at a significantly higher than average risk of readmission. This project was able to reduce readmission rates from 16.7% to 11.1% by simple patient education and readmission risk assessment. Readmissions are detrimental to both the patient and health care system. This project serves as a starting point for reducing readmissions not only in acute pancreatitis patients but potentially other diagnosis-specific readmission initiatives.

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