Self-reflection as a tool to increase hospitalist participation in readmission quality improvement

Background: Reducing 30-day readmissions is a national priority. Although multipronged programs have been shown to reduce readmissions, the role of the individual hospitalist physician in reducing readmissions is not clear. Objectives: We evaluated the effect of physicians' self-review of their own readmission cases on the 30-day readmission rate. Methods: Over a 1-year period, hospitalists were sent their individual readmission rates and cases on a weekly basis. They reviewed their cases and completed a data abstraction tool. In addition, a facilitator led small group discussion about common causes of readmission and ways to prevent such readmissions. Results: Our preintervention readmission rate was 16.16% and postintervention was 14.99% (P = .76). Among hospitalists on duty, nearly all participated in scheduled facilitated discussions. Self-review was completed in 67% of the cases. Conclusions: A facilitated reflective practice intervention increased hospitalist participation and awareness in the mission to reduce readmissions and this intervention resulted in a nonsignificant trend in readmission reduction.