The University of Kansas Cardiac Surgery Readmissions Committee: A Multidisciplinary Collaborative to Reduce Unplanned Readmissions

Unplanned readmissions negatively affect hospital reimbursement and mortality. The purpose of this study was to describe the inception of a multidisciplinary readmissions group designed to reduce unplanned cardiac surgery readmissions.

Unplanned cardiac surgery readmissions within 30 days of discharge between 2021 and 2024 were analyzed by the University of Kansas Cardiac Surgery Readmissions Committee, consisting of inpatient and outpatient advanced practice providers, data managers, emergency department personnel, and cardiac surgeons. In 2023, a goal-oriented working group was established to reduce readmissions. Cardiac surgery readmissions are reviewed daily, and the readmissions committee meets quarterly to discuss their findings and opportunities for improvement.

The working group's detailed investigation determined that arrhythmias, pleural effusions, and deep vein thrombosis or pulmonary embolism were the most common causes of readmission. The group then instituted postoperative amiodarone prophylaxis in their cardiac surgery patients, pursued aggressive postoperative drainage of the pleural spaces, and started prophylactic subcutaneous heparin on postoperative day 3 to reduce thromboembolic events. The group created a discharge checklist addressing rhythm issues, fluid balance, wound care, and clinic and on-call contact information. From 2021 to 2024, cardiac surgery readmissions declined from 10.9% to 9.6%, and similarly isolated readmissions after coronary artery bypass grafting declined from 10.2% to 6.1%, despite an increase in total operative volume and an increased case-mix index.

The creation of an integrated, multidisciplinary Cardiac Surgery Readmissions Committee Working Group allowed the group to design targeted interventions for the most common reasons for readmission, which in turn led to a reduction in readmission rates.