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01.01.2024 | Research

The impact of a multidisciplinary goals-of-care program on unplanned readmission rates at a comprehensive cancer center

verfasst von: Cerena Leung, Clark R. Andersen, Kaycee Wilson, Nico Nortje, Marina George, Christopher Flowers, Eduardo Bruera, David Hui

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2024

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Abstract

Purpose

This study examined the 30-day unplanned readmission rate in the medical oncology population before and after the implementation of an institution-wide multicomponent interdisciplinary goals of care (myGOC) program.

Methods

This retrospective study compared the 30-day unplanned readmission rates in consecutive medical patients during the pre-implementation period (May 1, 2019, to December 31, 2019) and the post-implementation period (May 1, 2020, to December 31, 2020). Secondary outcomes included 7-day unplanned readmission rates, inpatient do-not-resuscitate (DNR) orders, and palliative care consults. We randomly selected a hospitalization encounter for each unique patient during each study period for statistical analysis. A multivariate analysis model was used to examine the association between 30-day unplanned readmission rates and implementation of the myGOC program.

Results

There were 7028 and 5982 unique medical patients during the pre- and post-implementation period, respectively. The overall 30-day unplanned readmission rate decreased from 24.0 to 21.3% after implementation of the myGOC program. After adjusting for covariates, the myGOC program implementation remained significantly associated with a reduction in 30-day unplanned readmission rates (OR [95% CI] 0.85 [0.77, 0.95], p = 0.003). Other factors significantly associated with a decreased likelihood of a 30-day unplanned readmission were an inpatient DNR order, advanced care planning documentation, and an emergent admission type. We also observed a significant decrease in 7-day unplanned readmission rates (OR [95% CI] 0.75 [0.64, 0.89]) after implementation of the myGOC program.

Conclusion

The 30-day and 7-day unplanned readmission rates decreased in our hospital after implementation of a system-wide multicomponent GOC intervention.

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Titel: The impact of a multidisciplinary goals-of-care program on unplanned readmission rates at a comprehensive cancer center
verfasst von: Cerena Leung
Clark R. Andersen
Kaycee Wilson
Nico Nortje
Marina George
Christopher Flowers
Eduardo Bruera
David Hui
Publikationsdatum: 01.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 1/2024
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-023-08265-6

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The impact of a multidisciplinary goals-of-care program on unplanned readmission rates at a comprehensive cancer center