Identifying risk factors to reduce readmission rates for patients with psychiatric disorders: A quality improvement project




Sancho, Anastasia
Olayiwole, Folasade

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This QI project was a response to increased 30-day readmissions at an inpatient psychiatric facility in SW Texas, identified as the project site. The long-term goal is to decrease 30-day readmissions by patients with schizophrenia and/or bipolar disorder at the project site. An audit tool was created for this QI project by combining the READMIT clinical risk index and site-specific variables that were identified by site experts. Findings showed the numbers of repeat readmission (p = .000) and the age (p =.031) demonstrated statistical significance in 30-day readmissions. There was an association between the number of repeat readmissions and the READMIT Tool Score (rs = 0.57, p < .001). The correlation coefficient between the two variables was (rs = .0575), which is moderately significant. There was a significant positive association between the READMIT Tool Score and repeat numbers of readmissions: (rs = 0.57, p < .001). Findings also indicate two statistically significant risk factors (age and number of readmissions). One clinically significant variable (discharge on injectable long-acting antipsychotic medication) and higher READMIT clinical risk index scores were associated with 30-day readmissions. Recommendations include adding the top-three risk factors identified (age, number of readmissions, injectable medications at discharge) to the admission and discharge process implemented by repeated PDSA cycles. Other recommendations are to join a state or national registry to help track 30-day readmissions and to conduct a one-year study, including chart audits, to access changes in the specific population.


DNP Project


Schizophrenia, Bipolar, Quality improvement, 30 days’ readmissions, Audit tool, Medication non-adherence, Long acting injectable antipsychotic, Project site