ArticleProfessional case management
Impact of discharge planning decision support on time to readmission among older adult medical patients.
Article in Professional case management. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 70 citations in OpenAlex.
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- Engineering Safe Care Journeys: Designing a Patient Safety Passport.Journal of patient safety · 2025Article
- Predicting Youth and Young Adult Treatment Engagement in a Transdiagnostic Remote Intensive Outpatient Program: Latent Profile Analysis.JMIR formative research · 2023Article
- Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study.BMC geriatrics · 2023Article
- Factors Associated with Transfer from an Acute Geriatric Unit to a Post-Acute Care Facility among Community-Dwelling Patients: Results from the DAMAGE Cohort.Clinical interventions in aging · 2022Article
- The effectiveness of intermediate care including transitional care interventions on function, healthcare utilisation and costs: a scoping review.European geriatric medicine · 2020Article
- Factors Affecting Patient Prioritization Decisions at Admission to Home Healthcare: A Predictive Study to Develop a Risk Screening Tool.Computers, informatics, nursing : CIN · 2020Article
- Using a Decision Support Algorithm for Referrals to Post-Acute Care.Journal of the American Medical Directors Association · 2019Article
- Risks Perceived by Frail Male Patients, Family Caregivers and Clinicians in Hospital: Do they Change after Discharge? A Multiple Case Study.International journal of integrated care · 2019Article
- A Surgeon's Guide to Treating Older Patients with Colorectal Cancer.Current colorectal cancer reports · 2019Article
- What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis.BMC health services research · 2017Review
- Comparison of algorithm advice for post-acute care referral to usual clinical decision-making: examination of 30-day acute healthcare utilization.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2017Article
- Nurse Generated EHR Data Supports Post-Acute Care Referral Decision Making: Development and Validation of a Two-step Algorithm.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2017Article
- Patient Preferences for Information on Post-Acute Care Services.Research in gerontological nursing · 2016Article
- Higher 30-day and 60-day readmissions among patients who refuse post acute care services.The American journal of managed care · 2015Article
- Post-Acute Care Use and Hospital Readmission after Sepsis.Annals of the American Thoracic Society · 2015Observational
- Successful electronic implementation of discharge referral decision support has a positive impact on 30- and 60-day readmissions.Research in nursing & health · 2015Article
- Developing evidence-based tools from EHR data.Nursing management · 2014Article
- From unmet clinical need to entrepreneurship: taking your informatics solution to market.Studies in health technology and informatics · 2014Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
purpose of the studyHospital clinicians are overwhelmed with the volume of patients churning through the health care systems. The study purpose was to determine whether alerting case managers about high-risk patients by supplying decision support results in better discharge plans as evidenced by time to first hospital readmission. PRIMARY PRACTICE
settingFour medical units at one urban, university medical center. METHODOLOGY AND SAMPLE: A quasi-experimental study including a usual care and experimental phase with hospitalized English-speaking patients aged 55 years and older. The intervention included using an evidence-based screening tool, the Discharge Decision Support System (D2S2), that supports clinicians' discharge referral decision making by identifying high-risk patients upon admission who need a referral for post-acute care. The usual care phase included collection of the D2S2 information, but not sharing the information with case managers. The experimental phase included data collection and then sharing the results with the case managers. The study compared time to readmission between index discharge date and 30 and 60 days in patients in both groups (usual care vs. experimental).
resultsAfter sharing the D2S2 results, the percentage of referral or high-risk patients readmitted by 30 and 60 days decreased by 6% and 9%, respectively, representing a 26% relative reduction in readmissions for both periods. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Supplying decision support to identify high-risk patients recommended for postacute referral is associated with better discharge plans as evidenced by an increase in time to first hospital readmission. The tool supplies standardized information upon admission allowing more time to work with high-risk admissions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.