Pediatric Epilepsy Readmissions: The Who, When, and Why - 20/03/19
, Alexandria Lutley, MD a, c, Sharon W. Lake, PhD, RN d, Shirley Fledderjohn, RN a, Anna King, RN a, †, Paul S. Horn, PhD a, b, Kristen R. Wesselkamper, MD a, bAbstract |
Background |
Prior studies have demonstrated a pediatric epilepsy readmission rate of 6% to 10% but have not described details of the readmitted patients. We report the characteristics of pediatric patients admitted for epilepsy who were readmitted to the hospital within 30 days of discharge.
Methods |
An interdisciplinary team was established to individually review and characterize the 30-day readmissions of patients admitted for epilepsy from May 2014 to October 2016. The team contained both inpatient and outpatient neuroscience nurses, care managers, a quality outcomes manager, and child neurology physicians.
Results |
Over a 30-month period we had an all-cause 30-day readmission rate of 8.0%, which was 219 pediatric epilepsy readmissions from 169 patients. We found that 21.5% of readmissions were scheduled, 37% were for progression of chronic epilepsy, 9.6% were for recently diagnosed epilepsy, and 14.6% were for unrelated diagnoses. We classified 21.5% of readmissions as preventable and 64.9% as not preventable. Thirty-five percent of readmissions occurred within seven days of the initial discharge, including 29 of 47 (61.7%) preventable readmissions. The most common reasons for preventable readmissions were problems with the discharge care plan or medication management.
Conclusions |
We demonstrate that 21.5% of pediatric epilepsy readmissions were scheduled and 21.5% were judged to be preventable. The majority of preventable readmissions occurred within seven days of index discharge. Characterizing epilepsy readmissions is the first step in being able to reduce readmissions.
Le texte complet de cet article est disponible en PDF.Keywords : Epilepsy, Readmissions, Quality improvement, Pediatrics
Plan
| Financial disclosures: All authors have indicated they have no financial relationships relevant to this article to disclose. |
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| Funding source: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
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| Conflict of interest: All authors have indicated they have no potential conflicts of interest to disclose. |
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| Contributors' Statement: Drs. Lutley, Vawter-Lee, and Wesselkamper conceptualized and designed the study, collected data, drafted the initial manuscript, and reviewed and revised the manuscript. Prof. Horn carried out the analysis and interpretation of data and reviewed and revised the manuscript. RN Fledderjohn designed the study, designed data collection, collected data, and reviewed and revised the manuscript. RN King designed the study, designed data collection, and collected data. Prof. Lake conceptualized the study, designed the data collection database, and reviewed and revised the manuscript. All authors except for RN King approved the final manuscript as submitted and agree to be accountable for all aspects of the work. |
Vol 93
P. 11-16 - avril 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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