Derivation and validation of a hospital all-cause 30-day readmission index.

PURPOSE: The study derives and validates a 30-day hospital readmission risk index to predict a patient's likelihood of readmission, utilizing a health systems electronic medical record. METHODS: A retrospective data extraction and analysis was conducted using data from the electronic medical record to identify risks of 30-day all-cause hospital readmission on adult patients admitted to a large multi-site health system. Univariate and multivariable logistic regression was performed on a derivation cohort of hospital admissions (n = 40,668) and analyzed 91 variables associated with 30-day hospital readmission. A 10-variable risk prediction equation was generated and validated in a second patient cohort (n = 7,820). The prediction index's discriminative ability was determined using the c-statistic, and calibration of the prediction index was assessed with the use of the Hosmer-Lemeshow test. RESULTS: The hospital all-cause thirty-day readmission index (HATRIX) identified 10 variables to be highly associated with 30-day readmission. The discriminative ability of the derived prediction equation was determined using the c-statistic and was calculated to be 0.73 (95% confidence interval [CI] 0.72-0.73) for the derivation cohort. The prediction equation was validated using a second cohort of patients and resulted with an area under the curve (AUC) of 0.72 (95% CI 0.70-0.73), indicating modest discrimination. CONCLUSION: An original risk prediction index for 30-day hospital readmission was derived and validated using 2 cohorts of patients. Identifying patients who have an increased risk of 30-day hospital readmission with the use of the electronic medical record is an ideal method for targeting interventions and improving transitions-of-care to reduce hospital readmissions.

Implementing and sustaining a mentorship program at a college of pharmacy: The Keys to Successful Mentorship.

OBJECTIVE: To evaluate mentor and mentee opinions of The Keys to Successful Mentorship, a longitudinal student-led mentorship program established at a college of pharmacy. EDUCATIONAL ACTIVITY AND SETTING: In 2008, a mentorship program was created whereby first year pharmacy students (mentees) were paired with third year pharmacy students (mentors). An anonymous survey was administered to second (P2) and fourth (P4) year pharmacy students identifying strengths and weaknesses of the program. FINDINGS: Results of the survey administered to the P2 and P4 pharmacy students revealed that there was a strong desire to take part in the mentorship program. Of the respondents, 77% of P2 and 70% of P4 students stated the mentorship program aided in their professional growth. Mentors disagreed significantly more than mentees that participation in the program should be optional. Qualitative findings suggested that the program assisted students in building professional relationships and networks, better prepared them for experiential training, and helped with post-graduate decisions. CONCLUSION: The implementation of a longitudinal student-led mentorship program was supported by student pharmacists and may aid in their professional development.