Community Transition: Addressing Factors that Lead to Readmission in Inpatient Psychiatric Units

Abstract

Psychiatric readmission is a common problem for individuals with psychiatric illness worldwide. Approximately one in seven individuals hospitalized for psychiatric illness are readmitted within 30 days of discharge. 30-day readmission is a common outcome measure to indicate quality of patient care. Frequent readmission for patients decreases their quality of life, disrupts their recovery, and fosters dependence on psychiatric services. The purpose of this doctoral capstone experience is to develop a clinically useful screening tool used to identify at-risk patients for readmission to improve transition into the community. In doing so, effective patient-centered interventions focused on individualized needs can be provided to possibly decrease the risk of readmission. The screening tool was developed using retrospective clinical data collected from electronic medical records of all patients readmitted to SEMHRC within 30 days of discharge in 2020. The screening tool examines 5 domains which include previous admissions, risk of harm to self and others, individual factors, community barriers, and engagement in treatment. In 2020, Sandra Eskenazi Mental Health Recovery Center discharged 1,119 patients. Of those patients discharged, 10.3% readmitted within 30 days at least one or more times. A bivariate analysis was done using the developed screening tool on 19 patients that were first time users of the psychiatric unit comparing their hospital index admission to following hospital readmissions. These patients averaged a score of seven on the screening tool for risk of readmission. Individuals with 3+ readmissions within 30 days of prior hospitalization had an average score of 12.7 upon assessment. The study showed that the higher score on the screening tool increased the probability of readmission. The study shows the use of a screening tool to assess patients' risk of readmission on a psychiatric unit has the potential to improve delivery of mental health services.