Dr. Aviva Asnis-Alibozek
Purpose: The purpose of this article is to assess the impact of multidisciplinary rounds (MDR) and predictive risk tools on 30-day readmissions and mortality in hospitalized patients with a diagnosis of heart failure (HF) or pneumonia (PNA).
Method: PubMed and Google Scholar literature search was conducted with search terms multidisciplinary rounding, predictive risk tools, 30-day readmissions, HF and readmissions and mortality, and PNA and readmissions and mortality. Forty-five relevant articles were retrieved and served as the basis for this clinical review. Interim outcomes from the MyMichigan Health Pilot Program using MDR and a predictive risk tool in practice are presented as a case study. Results: The available evidence shows a mixed consensus on whether MDR affects outcomes for HF and PNA. Some studies demonstrate improved patient outcomes and lower readmission rates in high-risk patients. More studies regarding MDR and patient satisfaction are available than studies on MDRs impacting HF and PNA outcomes and mortality. There is evidence to suggest a more precise definition of what MDR is needed to appreciate the full potential of MDR and how it affects outcomes and mortality.
The Hospital Readmissions Reduction Program (HRRP) initiative introduced in 2012 aimed to incentivize hospitals to reduce readmission rates, morbidity, and mortality among hospitalized patients, but evidence suggests that implementation may have had an unintended negative impact on long-term patient outcomes.
Overall, Predictive Risk tool studies show inconsistency in their predictive ability for high-risk admissions, although some validated tools have demonstrated value.
Conclusion: A review of the research available since 2016 shows that MDR, despite its inconsistent definition and membership, can be beneficial in the collaboration and coordination of care, patient satisfaction, and patient-centered care with the potential for reduced costs and decreased length of stay. More research is needed to study how MDR and HRRP impacts 30-day readmissions and mortality of HF and PNA patients; but what is available appears to show a potentially positive impact for MDR. Evidence for the use of predictive risk tools as a means of reducing hospital readmissions is limited and requires further study with validated tools.
Schisler KA. The Impact of Multidisciplinary Rounds and Predictive Risk Tools on 30-day Readmissions and Mortality Outcomes in Hospitalized Patients with Heart Failure and Pneumonia. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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