Provider attitudes and practice of recommended guidelines to reduce readmissions among low income minority patients

In recognition of the contributory role of patient, provider, and systems related factors to failure in transitions of care, recommendations have been made by healthcare organizations regarding best practices to improve transitions of care and reduce readmissions. The role of provider attitudes and adherence to recommended practice guidelines in care transitions has not been studied. The present study sought to determine provider attitudes and actual practice of recommended best practice strategies aimed at promoting optimal transitions of care.A cross-sectional survey was conducted among key healthcare providers involved in the discharge process at the Grady Memorial Hospital, a 953 bed academically affiliated urban safety net hospital. Of these, 131 participants completed the surveys including 73 internal medicine residents, 7 social workers, 51 nurses (5 nurse case managers, 6 inpatient unit nursing directors and charge nurses and 40 bedside nurses). There was a variation as to consideration of importance of best practices across healthcare disciplines consistent with the practice focus of each discipline. Medication reconciliation however seemed to be considered equally important across disciplines. Coordination of care, use of a multidisciplinary team and discussion of goals of care were practices considered to be least important. There was a significant discrepancy between consideration of importance of best practices and actual practice of these.This study has shown areas where key providers involved in the discharge process are not adhering to guidelines recommended to reduce readmissions. Future studies to determine barriers to guideline adherence are needed along with targeted interventions to promote provider adherence.