A newly developed tool can identify children’s readmission risk before discharge

Data available in electronic health records (EHR) can be used to identify readmission risk for children of all ages while they are still in the hospital, according to a study from the Ann & Robert H. Lurie Children’s Hospital of Chicago published in the journal JAMA Network Open. The newly developed and validated tool will be key to efforts to reduce hospitalizations within 30 days of discharge, which should also help free up scarce hospital beds for children.

Although hospital readmissions are a quality measure, to date we have lacked a comprehensive and easy-to-use instrument to predict the risk of pediatric readmissions prior to discharge. Knowing which children are most likely to require another hospitalization soon after their first stay allows us to be proactive and better focus discharge planning to reduce the high risk of readmission.”

Denise M. Goodman, MD, MS, lead author, Critical Care Physician at Lurie Children’s and Professor of Pediatrics at Northwestern University Feinberg School of Medicine

Dr. Goodman and colleagues used data from three years of discharges at Lurie Children’s to derive and validate a suite of three readmission prediction models for children of all ages, including infants younger than 28 days. To calculate readmission risk, these models use demographic and socioeconomic data from the EHR, as well as clinical variables such as continued length of stay, use of specific therapies, and previous hospitalizations.

“A major strength of our predictive models is that they were designed to be implemented in the EHR during the hospital stay and to change with the clinical setting,” said Dr. A good man. “The risk can be recalculated daily, allowing us to tailor a discharge plan in real time.”

Reducing the risk of readmissions also helps hospitals create pediatric beds, which are increasingly scarce in Chicago, across Illinois and nationally.

“Given the growing shortage of pediatric beds, reducing the likelihood that a child will need to return to the hospital within 30 days is critical,” added senior author Matthew M. Davis, MD, MAPP, chair of the Department of Pediatrics. at Lurie Children’s and Northwestern University Feinberg School of Medicine. “We believe our readmission forecasting is the most comprehensive hospital has to meet the needs of children and their families before discharge, reducing the risk of rehospitalization.”


Ann & Robert H. Lurie Children’s Hospital of Chicago

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