Aims:
Problem: There are high numbers of unplanned readmissions within the geriatric population following an acute medical admission. We noticed a similar trend in our Rapid Access Treatment Unit for Geriatric medicine at Fremantle Hospital. The aim of this audit was to understand the population at high risk of readmission and put in place strategies to reduce readmission rates.
Methods:
Design/Methods: We collected data relating to patients readmitted within 30 days of discharge over a two-month period (July to August 2021) including diagnoses, readmission reason, cognitive status, discharge destination and services on discharge using electronic medical records to better understand reasons for unplanned readmission.
Practice Change/Re-audit: We implemented a discharge checklist, taped to our mobile workstations, to prompt organisation of follow-up in the community prior to discharge and appropriate linkage with outpatient services. We also provided ward level education to staff regarding reasons for readmission.
Results:
Of the 195 patients discharged from RATU over that two-month period, 19% of patients were readmitted. The average age was 84, ranging from 66-103. Falls accounted for the majority of readmissions with IECOPD being the second most common reason. 11% of patients had a pre-existing cognitive impairment and the average clinical frailty score (CFS) was 4-6. During the period of re-auditing, the overall readmission rate fell to 12%.
Conclusions:
Geriatric patients are at high risk of readmission following an acute presentation. By understanding the risk factors for readmission on an individual ward level, those at highest risk of readmission can be more closely followed up and readmission rates reduced.