The latest issue of Annals of Internal Medicine (AIM) includes 10 systematic reviews on topics related to patient safety. One, by Stephanie Rennke and colleagues pertains to transitions of care, which is relevant to hospital readmissions.
Little information is available on effective transitional care strategies for general medical inpatients. Prominent national organizations have recommended a range of interventions (14), which are being implemented widely. However, little evidence supports their effect on readmissions or other important markers of postdischarge patient safety, such as emergency department (ED) visits and AEs [adverse events] occurring shortly after discharge. Moreover, a recent review (15) identified no interventions proven to reduce 30-day readmission rates in general patient populations, although it did not focus on hospital-initiated interventions. [Hyperlink added.]
The authors point to one intervention that was successful at reducing 30-day hospital readmissions in several settings, the Care Transitions Intervention (CTI) in which a “transition coach” conducted “postdischarge home visits that emphasized patient education and self-management.”
In part due to limitations in study designs, their conclusion is that we don’t yet know enough about how to generalize implementation of successful strategies.
Although hospitals are now being penalized for excessive readmission rates, the strategies that an individual hospital can implement to improve transitional care remain largely undefined.
This and the other studies in the current AIM are ungated.