New study on hospital readmittance
A new study co-led by St. Michael's Hospital and the University Health Network (UHN) in Canada has found that patients that experience disturbances in sleep, mobility, nutrition or mood while admitted in hospital may be more likely to be readmitted within 30 days after discharge. The research found that nearly all of the 207 patients who participated in the study reported disturbance in at least one category in hospital. Sixty-five per cent of patients reported disturbance in more than one category and around 30 per cent reported disturbances in three or four categories. Those with disturbance in three or four categories were classified as patients with 'high trauma of hospitalisation' and had a 16-per-cent higher risk of readmission to hospital after discharge.
“Everyone who works at a hospital knows intuitively that the disruptive hospital environment has a profound impact on patients, but with this research, we have a clearer picture of the scale of the problem and we now know that it could affect patient outcomes,” said Dr Amol Verma, a physician at St. Michael's who co-led the study and co-founded GEMINI. “This study pointed out three major things we didn't know previously. First, we didn't know how common and connected these disturbances were. Second, we learned that patient experience is linked to patient outcomes and the cumulative effect for disturbances has more impact than disturbance in only one domain. Third, this study suggests that we might be able to improve patient experience and outcomes at the same time.”
The research was based on participants from two large, urban, academic hospitals, St. Michael's and the Toronto Western Hospital of UHN, who were admitted to the internal medicine ward for more than 48 hours. The research team interviewed participants using a questionnaire before discharge to gauge their disturbance in-hospital in the four categories: sleep, mobility, nutrition and mood.
The team is now working with colleagues in other cities to validate their findings and is in the process of developing potential solutions to improve hospital experience. “The next thing is to try to re-design hospital care to try to improve people's sleep, nutrition, mobility, and mood without losing efficiency,” said Dr Verma. “Our plan is to try and work with a group of patients, frontline healthcare providers and everyone else who participates in a patient's care, like hospital meal staff, to co-design an intervention to improve the experience of care in hospital.”