Multidisciplinary Bedside Huddles Reduce Readmissions in High-Risk Patients

Readmission rates have a significant impact on hospital systems, from financial performance to patient satisfaction. Determining efficient, effective interventions to reduce readmission rates is imperative to improving hospital and patient outcomes.

To develop and evaluate a multidisciplinary discharge process for high-risk patients that is cost-effective, achieves high uptake in a large academic health center, and decreases readmissions.

A multiphase intervention was implemented at a large academic hospital. The Phase 1 pilot, performed on a single inpatient unit, implemented a multidisciplinary bedside huddle 24 to 48 hours prior to discharge for patients at high risk for readmission based on a previously validated risk score.

Phase 1 showed a reduction in readmission rates for high-risk patients from 36% (pre-intervention) to 20% (post-intervention). In Phase 2, the huddle was expanded to 2 units: 1 "opt-in" and 1 "opt-out." Huddle uptake was higher on the opt-out unit (89% vs 4%) and associated with lower readmission rates for patients receiving huddles (20.9% vs 40%) and for those on the opt-out unit (28.3% vs 38.7%). In Phase 3, the huddle was expanded to all units and showed a sustained lower readmission rate for those receiving a predischarge huddle than those who did not (26.13% vs 33.78%).

For patients at high risk of readmission, a predischarge multidisciplinary bedside huddle utilizing an opt-out implementation model reduces readmissions.