Changes in staff scheduling were linked to a 26 percent increase in hospital readmissions 28 days post-discharge at a large Canadian teaching hospital, according to a new study published in The American Journal of Medicine.
For the study, researchers examined patient discharges between 2004 and 2013 at Sunnybrook Health Sciences Centre in Toronto. In 2009, the hospital changed its organization of physician teams. Prior to the change, physicians remained together throughout an entire shift, with four separate teams covering 24-hour periods. The new system disbursed senior and junior residents across the four shifts in an attempt to increase the continuity of care for the patients.
The researchers were able to establish the readmission rates for 89,697 discharges — 37,982 before the call system change and 51,715 after the switch. After adjusting for each patient's likelihood of readmission, researchers were able to determine that the change in the physician call system was linked to a 26 percent increase in readmission rates.
Donald A. Redelmeier, MD, of the University of Toronto, said, "Together, the findings show that well-intentioned and well-received changes aimed at improving physician call systems can have unintended, undesirable and unrecognized consequences."
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