Looking for Studies Linking Death Within 24–48h Post-Discharge to Missed Diagnoses or Suboptimal In-Hospital Care

[Juicyfruit12]

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Internal Medicine colleagues — I’m looking to gather any studies, case series, or quality improvement reviews that show a strong association between patient death occurring within 24–48 hours after hospital discharge and factors such as:

• Missed or delayed diagnosis
• Suboptimal treatment plans
• Failure to act on abnormal labs or imaging
• Poor discharge planning or premature discharge
• Lack of post-discharge follow-up instructions or continuity of care

Have any of you come across published literature (even VA-based reviews or quality initiatives) that establish this association? Peer-reviewed articles would be ideal, but well-documented QI reports or mortality reviews are also helpful. Thanks in advance!

 

[chessknt]

Internal Medicine colleagues — I’m looking to gather any studies, case series, or quality improvement reviews that show a strong association between patient death occurring within 24–48 hours after hospital discharge and factors such as:

• Missed or delayed diagnosis
• Suboptimal treatment plans
• Failure to act on abnormal labs or imaging
• Poor discharge planning or premature discharge
• Lack of post-discharge follow-up instructions or continuity of care

Have any of you come across published literature (even VA-based reviews or quality initiatives) that establish this association? Peer-reviewed articles would be ideal, but well-documented QI reports or mortality reviews are also helpful. Thanks in advance

It won't exist since the entire premise of this question is ridiculous. How/who would define any of your variables? Why did you choose the harshest endpoint? If you think this is doable I encourage you to try to do it, even just at a local level, and see what your IRB says or how successful you are at even coming up with appropriate definitions for 'suboptimal treatment plans' or 'failure to act on abnormal labs' or 'poor discharge planning'.

 

[NotAProgDirector]

Such a study would be as impractical as an RCT assessing whether parachutes prevent injuries when jumping from aircraft.

 

[dozitgetchahi]

Such a study would be as impractical as an RCT assessing whether parachutes prevent injuries when jumping from aircraft.

Better yet, the study would show that parachutes only have “minimal efficacy”, with the authors suggesting that this may be a “paradigm shift in how we manage people jumping from airplanes”.

 

[HemeOncHopeful19]

This sounds like a medmal lawyer trying to get us to do your homework for you

 

[LoudBark]

Internal Medicine colleagues — I’m looking to gather any studies, case series, or quality improvement reviews that show a strong association between patient death occurring within 24–48 hours after hospital discharge and factors such as:

• Missed or delayed diagnosis
• Suboptimal treatment plans
• Failure to act on abnormal labs or imaging
• Poor discharge planning or premature discharge
• Lack of post-discharge follow-up instructions or continuity of care

Have any of you come across published literature (even VA-based reviews or quality initiatives) that establish this association? Peer-reviewed articles would be ideal, but well-documented QI reports or mortality reviews are also helpful. Thanks in advance!

Many years ago you posted that you were a PM and R doc that did not go to a good med school or residency (your words from your previous posts), did not like clinical medicine, and you were leaving clinical medicine to maybe get an MBA and go in to business. So why do even care about any of this?

 

[gutonc]

Many years ago you posted that you were a PM and R doc that did not go to a good med school or residency (your words from your previous posts), did not like clinical medicine, and you were leaving clinical medicine to maybe get an MBA and go in to business. So why do even care about any of this?

Probably went to law school instead.

 

[chessknt]

Probably went to law school instead.

They should go back because they still have some learnin to do.