Self-reflection as a Tool to Increase Hospitalist Participation in Readmission Quality Improvement

Reducing 30-day readmissions is a national priority. Although multipronged programs have been shown to reduce readmissions, the role of the individual hospitalist physician in reducing readmissions is not clear.

We evaluated the effect of physicians' self-review of their own readmission cases on the 30-day readmission rate.

Over a 1-year period, hospitalists were sent their individual readmission rates and cases on a weekly basis. They reviewed their cases and completed a data abstraction tool. In addition, a facilitator led small group discussion about common causes of readmission and ways to prevent such readmissions.

Our preintervention readmission rate was 16.16% and postintervention was 14.99% (P = .76). Among hospitalists on duty, nearly all participated in scheduled facilitated discussions. Self-review was completed in 67% of the cases.

A facilitated reflective practice intervention increased hospitalist participation and awareness in the mission to reduce readmissions and this intervention resulted in a nonsignificant trend in readmission reduction.