Development of Hospital Performance Indicator Report System for 28-day Unplanned Re-admission

Abstract

A hospital performance indicator for 28-day unplanned re-admission rates i s a measure that reflects the patient care system while being treated in a hospital. The analysis of system metrics on un­planned re-admission indicated duplication of reports up to 16.67% of the cases and no report on the risk in the system in 53.33%. Therefore, there is a need to address the problem of hospital reporting performance indicator in order to obtain reliability of data for monitoring the situation, particularly the readmission of patients within 28 days. This action research aimed to develop the reporting system and to study the outcomes of such improvement with regard to unplanned re-admission rate. The study was con­ducted from January 2015 to September 2016. The key informants include 40 registered nurses and two information nurses. The research had three stages included: planning, acting and evaluation & reflecting. Data were analyzed using content analysis and descriptive statistics with frequency and percentage. The study findings were as follows: (A) the system metrics report unplanned re-admission rate included in­puts with the nursing admission form as a warning to report of risks, nurse information database program, health agency menu, still nursing topics & risk. The Process stage including (1) nurses receiving patient readmission, (2) recording in the first form, (3) incident reporting, (4) selecting Q06 (risk code for unplanned re-admission, (5) monthly review and compilation, and (6) supervisors getting the new re­sults. Eventually, the outcomes including application performance reporting metrics were obtained. (B) The development of the effectiveness of the program included the complete access (100.0%) to detailed information indicators. From the evaluation of the program, it was found that the program helped defining the risk report Q06 faster (90.0%), feasible (87.5%), facilitated the collection of metrics reports on unplanned re-admission rate (87.5%), gaining high satisfaction (87.5%), and suitable (82.5%). These indicators helped the head nurses appraise the quality of patient care leading to the review and correct the problem promptly. The discharge planning measures were appropriate to each patient and leading to the reporting and monitoring of the indicators regularly in the monthly meetings of the hospital.