MURA-ED: Mitigating Unnecessary Readmissions and Admissions in Emergency Departments

Unnecessary readmissions have become a recurring problem in the Emergency Departments (ED) across the United States. There is little research on the perspectives of stakeholders across the healthcare organization on this issue. This research study provides a multi-level stakeholder-centered view to identify contributors to unnecessary ED readmissions. In our study we used two novel techniques to improve the system-wide elicitation of views and synthesis of findings from a systems perspective. First, we developed a system hierarchy diagram to inform our selection of participants such that representative views covering the depth and breadth of the healthcare system are included. Interviews were conducted with relevant stakeholders at different levels of the hierarchy of a representative U.S. healthcare system, including senior leadership, clinical management, and front-line patient care. Thematic analysis was conducted to identify relevant contributors and potential solutions based on stakeholders’ perspectives. Second, a bipartite network representation was used to investigate how the identified contributors were related to the set of potential solutions based on stakeholders’ feedback. The findings from our multi-level stakeholder-centered approach enabled by systems engineering methods may inform the development of practical and sustainable mitigation strategies to reduce unnecessary readmissions.

• Sponsors: NSF Center for Health Organization Transformation (CHOT)
• Researchers: Sam Bonet Olivencia
• Contact: samuel089@tamu.edu