CURIOS@ is a prospective multi-centre cross-sectional study to investigate readmissions in participating units. The data collected is derived from two clinical episodes: the episode containing the re-admission and the previous admission (index admission). The main aims are: Outcomes: * Risk factors to predict preventable readmissions in non-surgical patients * Percentage of subjectively non-preventable and preventable readmissions from patient, carer, their nurses and their physician's point of view * Comparison for risk factors on readmissions throughout Europe * Increasing awareness and knowledge for health-care workers on readmissions and its preventability
Data will be derived directly from patients, from the clinical notes of the previous admission and records of discharge communication. Also information from treating physicians, nurses and immediate caregivers will be collected. The data set will contain no directly identifiable variables (data will be registered by using a research code for each patient). Data collection will include: Hospital-related data, patient-related data, health-related data, time-related data, and physician related data. Also patient feedback is requested. After obtaining written informed consent, the researcher will ask the patient 7 questions about the (preventability of their) readmission. Also the patient will be asked if one of the direct carers can be approached with 2 questions. The carer will most often be a sibling, a good friend or someone from the neighborhood. We will approach the carer in person or by telephone, and only after explicit permission from the patient. Lastly, we will ask a doctor and nurse (responsible for the patient in the first 24 hours of his readmission) similar questions.
Study Type
OBSERVATIONAL
Enrollment
1,000
Hospital of South West Jutland
Esbjerg, Denmark
VU University Medical Centre
Amsterdam, North Holland, Netherlands
Academic Medical Centre (AMC)
Amsterdam, Netherlands
Albert Schweitzer
Dordrecht, Netherlands
Westfriesgasthuis
Hoorn, Netherlands
VieCuri Hospital
Venlo, Netherlands
Ysbyty Gwynedd Hospital
Bangor, United Kingdom
University Hospital of South Manchester
Manchester, United Kingdom
Percentage of readmissions deemed preventable by patients, their informal carers, nurses and physicians
Of all the readmissions in the study, we will look at the readmissions which are deemed potentially preventable (YES or NO) by all partners of care chain. In the end this will give us a percentage of readmissions judged as potentially preventable by all partners of care chain.
Time frame: 1 year
Causes of preventable readmissions
We will ask all partners in the care chain about the causes of the readmissions. These will be categorised: Disease-related: Natural progress disease, out of control/influence physician or patient - for example: metastasis cancer. Patient-related: Related to control/influence patient, out of control/influence professionals - for example: a patient who refused extra home care after the index admission. Human/caregiver-related: Related to the control/influence professionals - for example: poor medication handover after index inclusion. Organisational: Readmission related to organisational problems - for example: no beds available, transfer from other hospital etc. Technical: Readmission related to technical defects of materials or equipment - for example: IV-drip home infusion antibiotics broken.
Time frame: 1 year
Risk factors for preventable readmissions
For every readmission, we will ask researchers to fill out a dataset with potential risk factors. These are: 1. General data regarding readmission: i.e. length of stay, time between index admission and readmission. 2. Patient-related factors: i.e. age, sex, marital status, living situation etc. 3. Health-related: ie. comorbiditity, frailty score, polypharmacy etc. 4. Time-related: i.e. Total admissions in previous year 5. Physician related: i.e. was a discharge letter send?
Time frame: 1 year
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