Multidisciplinary Bedside Huddles Reduce Readmissions in High-Risk Patients

Abstract

Introduction: Readmission rates have a significant impact on hospital systems, from financial performance to patient satisfaction. Determining efficient, effective interventions to reduce readmission rates is imperative to improving hospital and patient outcomes.

Objectives: To develop and evaluate a multidisciplinary discharge process for high-risk patients that is cost-effective, achieves high uptake in a large academic health center, and decreases readmissions.

Methods: A multiphase intervention was implemented at a large academic hospital. The Phase 1 pilot, performed on a single inpatient unit, implemented a multidisciplinary bedside huddle 24 to 48 hours prior to discharge for patients at high risk for readmission based on a previously validated risk score.

Results: Phase 1 showed a reduction in readmission rates for high-risk patients from 36% (pre-intervention) to 20% (post-intervention). In Phase 2, the huddle was expanded to 2 units: 1 "opt-in" and 1 "opt-out." Huddle uptake was higher on the opt-out unit (89% vs 4%) and associated with lower readmission rates for patients receiving huddles (20.9% vs 40%) and for those on the opt-out unit (28.3% vs 38.7%). In Phase 3, the huddle was expanded to all units and showed a sustained lower readmission rate for those receiving a predischarge huddle than those who did not (26.13% vs 33.78%).

Conclusions: For patients at high risk of readmission, a predischarge multidisciplinary bedside huddle utilizing an opt-out implementation model reduces readmissions.