York U leads research on tool to assess hospital patient readmission risk

Entrance of NYGH
Entrance of NYGH

A team of researchers led by York University Professor Christo El Morr has published its findings on the success of using a specific real-time tool to assess the risk of unplanned readmission of hospital patients.

Christo El Morr

The two-year collaborative project was funded by North York General Hospital Exploration Fund, and the team included Professor Liane Ginsburg (Co-PI) from York University, York U School of Health Policy & Management undergraduate student Seungree Nam, and Susan Wollard, director of the Medical, Critical Care & Elderly Care Program at North York General Hospital.

The study, “Assessing the Performance of a Modified LACE Index (LACE-rt) to Predict Unplanned Readmission After Discharge in a Community Teaching Hospital,” was published in JMIR Publications here: i-jmr.org/2017/1/e2.

Liane Ginsburg

The LACE index is used to predict unplanned readmission of patients, or patient death, after discharge, and considers the length of stay; the acuity of admission; co-morbidities; and the number of emergency department visits within the past six months. However, until now, its implementation and use on a daily basis in real-life situations were never assessed. The team adapted LACE for implementation in a hospital setting; the adapted LACE was used in real time, hence the name LACE-rt, said Ginsburg.

“Our team assessed LACE-rt and found it a fair tool for identifying patients at high risk of readmission,” said El Morr. “We found high-risk patients are 2.648 times more likely to be readmitted than those at low risk. We have also identified data entry errors caused by a lack of information system integration.”

The team, he said, has already designed an updated version of the software interface that minimizes data entry and avoids errors, and has developed plans to assess interventions targeting readmission reduction.

Susan Woollard

“The project highlights the need for collaborative efforts that bridge acute and community care sectors,” said Ginsburg.

Assessing readmission risk and reducing hospital readmission to acute care is of paramount importance for patient health, quality of care and cost reduction, said El Morr.

“The collaborative work between researchers in the School of Health Policy & Management and collaborators at North York General Hospital has culminated in a new understanding of the performance of LACE index in a real-life environment,” said El Morr. “The collaboration with North York General Hospital was an excellent experience; we encountered positive leadership and supportive environment. It allowed Prof. Ginsburg and myself to engage our students in experiential learning and produce research that has impact.”

Wollard said of the project: “I think this is a tremendous work that will support our discharge planning in the future. The collaboration has been so satisfying.”