Decreasing 30-day hospital readmissions by addressing social determinants of health using a bundled discharge approach: An evidence-based practice project recommendations

IntroductionEvidence from the literature suggests that social determinants of health (SDOH) account for 80% of health outcomes and are associated with hospital readmissions. Readmissions negatively impact the quality of life of patients and increase healthcare costs. The Agency for Healthcare Research and Quality reports that there were 3.8 million 30-day adult hospital readmissions in 2018 with an average readmission cost of $15,000.MethodsA literature search in CINAHL, PubMed, ClinicalKey, Google Scholar, and Medline databases using the keywords "SDOH", "social determinants of health", "healthcare disparities", "patient discharge", "readmission", "interdisciplinary", and "multidisciplinary" yielded 287 articles. After title and abstract screening and a full-text review of 90 articles, five articles were selected for critical appraisal. We used the critical appraisal skills programme (CASP) and Appraisal of Guidelines for Research & Evaluation II (AGREE II) tools for the selected articles' appraisal process.ResultsTen high-quality strong evidence recommendations emerged from the evidence review process. These recommendations were bundled together to create an evidence-based methodology to decrease 30-day readmissions.ConclusionThe findings provide strong evidence of the effectiveness of a bundled discharge approach in reducing hospital readmissions and improving patient outcomes.