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Related Concept Videos

Data Validation01:03

Data Validation

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Data validation is an essential part of a comprehensive assessment. Validation is confirming or verifying and opening the door to gathering more assessment data as it clarifies vague or unclear data. The process of checking and verifying the collected information is called data validation. The primary purpose of data validation is to ensure data is as free from error, bias, and misinterpretation as possible.
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Documentation of Nursing Diagnosis01:10

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The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
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Planning Nursing Care I01:21

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The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
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Related Experiment Video

Updated: Apr 7, 2026

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
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Development and Validation of an Algorithm to Identify Planned Readmissions From Claims Data.

Leora I Horwitz1,2,3, Jacqueline N Grady4, Dorothy B Cohen4

  • 1Division of Healthcare Delivery Science, Department of Population Health, New York University School of Medicine, New York, New York.

Journal of Hospital Medicine
|July 8, 2015
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Summary

This study developed an algorithm to identify planned hospital readmissions, improving the accuracy of readmission measures. The tool helps distinguish deliberate care from unplanned events for better healthcare quality reporting.

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Area of Science:

  • Health Services Research
  • Healthcare Quality Improvement
  • Health Informatics

Background:

  • Planned readmissions represent scheduled care and should be excluded from readmission performance measures.
  • Accurate identification of planned readmissions is crucial for meaningful healthcare quality assessment.

Purpose of the Study:

  • To develop and validate an administrative claims-based algorithm for identifying planned hospital readmissions.
  • To assess the performance characteristics of the developed algorithm.
  • To identify potential improvements for algorithm accuracy.

Main Methods:

  • Consensus-driven algorithm development involving 27 experts.
  • Validation study conducted across 7 acute-care hospitals in 2 health systems.
  • Chart review used as the gold standard for validating algorithm performance (sensitivity, specificity, predictive values).

Main Results:

  • The algorithm identified 7.8% of readmissions as planned.
  • The initial algorithm (v2.1) demonstrated a weighted sensitivity of 45.1% and specificity of 95.9%.
  • A revised algorithm showed improved sensitivity (49.8%) and positive predictive value (58.7%), though PPV was low for specific procedures like cardiac catheterization.

Conclusions:

  • An administrative claims-based algorithm for identifying planned readmissions is feasible.
  • This algorithm can facilitate more accurate public reporting of hospital readmission measures, focusing on unplanned events.
  • Further refinement may be needed for specific high-volume planned procedures.