Exploring Psychiatric Re-Admission Factors through a Loretto Hospital Quality Improvement Initiative

Abstract

Objective:This quality improvement project aims to comprehensively grasp the factors driving rapid readmissions by analyzing demographic patterns at The Loretto Hospital (TLH). Introduction: The rising occurrence of rapid readmissions within psychiatric units poses a significant concern, particularly in socioeconomically challenged regions. Prior research has spotlighted specific contributors to readmissions, including suicide-related concerns and substance/alcohol abuse. Notably, outpatient care has emerged as a preventive factor. The pivotal role of The Loretto Hospital in the Austin community is underscored by the 2016 American Community Survey, revealing substantial challenges like high poverty rates, limited educational attainment, low median household income, and prevalent alcohol and substance abuse. Methodology:Leveraging the Meditech Electronic Medical Record (EMR) system, this study will identify a cohort of over 50 patients with two or more admissions in the last year. Both genders aged 18 and above will be included, with support from medical students in patient selection. Chief complaints, education, employment, medication adherence, living conditions, substance abuse, and outpatient engagement will be assessed. Using SPSS Software, data analysis employed multiple linear regression to uncover correlations between identified factors and readmission instances. Results:Contributors identified are TLH outpatient care, major chief complaints as suicidal ideation and hallucination, unemployment status, substance abuse, and medication nonadherence. Conclusion:This study underscores the importance of enhancing substance abuse management, medication adherence, and social support to curtail readmission rates. The noted correlation between TLH's outpatient care and readmissions suggests a potential link between the care approach and patient behavior. Proposed strategies span integrated substance abuse screening, tailored medication plans, regular follow-ups, local resource connections, dedicated case management, peer mentorship initiatives, and ongoing readmission rate tracking for refinement. Implementation of these strategies establishes a comprehensive framework to reduce readmissions, elevate care quality, and enhance patient outcomes.