Evidence map›Paper›PMID 29627815›Full record

ArticleBMJ open2018

Protocol for a mixed methods study of hospital readmissions: sensemaking in Veterans Health Administration healthcare system in the USA.

Lauren S Penney, Luci K Leykum, Polly Noël, Erin P Finley, Holly Jordan Lanham, Jacqueline Pugh

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 2 countries.

Lauren S PenneyResearch Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.ORCID 0000-0002-8285-7352
Luci K LeykumResearch Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.
Polly NoëlDepartment of Family and Community Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
Erin P FinleyResearch Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.
Holly Jordan LanhamResearch Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.
Jacqueline PughResearch Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.
The University of Texas Health Science Center at San Antonio · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEffective delivery of healthcare in complex systems requires managing interdependencies between professions and organisational units. Reducing 30-day hospital readmissions may be one of the most complex tasks that a healthcare system can undertake. We propose that these less than optimal outcomes are related to difficulties managing the complex interdependencies among organisational units and to a lack of effective sensemaking among individuals and organisational units regarding how best to coordinate patient needs. METHODS AND ANALYSIS: This is a mixed method, multistepped study. We will conduct in-depth qualitative organisational case studies in 10 Veterans Health Administration facilities (6 with improving and 4 with worsening readmission rates), focusing on relationships, sensemaking and improvisation around care transition processes intended to reduce early readmissions. Data will be gathered through multiple methods (eg, chart reviews, surveys, interviews, observations) and analysed using analytic memos, qualitative coding and statistical analyses. We will construct an agent-based model based on those results to explore the influence of sensemaking and specific care transition processes on early readmissions. ETHICS AND DISSEMINATION: Ethical approval has been obtained through the Institutional Review Board of the University of Texas Health Science Center at San Antonio (approval number: 14-258 hour). We will disseminate our findings in manuscripts in peer-reviewed journals, professional conferences and through short reports back to participating entities and stakeholders.

Indexed as

Patient ReadmissionVeterans HealthHumansPatient TransferUnited StatesUnited States Department of Veterans AffairsVeteranscomplexity sciencehospital readmissionssensemakingtransitions of careveterans

Identifiers

PMID29627815
PMCPMC5892745
OpenAlexW2795443352

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.