You're the detective

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Steven Littlehale
Steven Littlehale

In the evidence-based healthcare world, you need to become a real Sherlock (or Shirley) Holmes to take your clues (data) and put them together logically (analyze the data) to make analytics-based decisions to solve your facility's most challenging mysteries. 

Your success as an investigator depends on finding and then making sense of the clues. The rest is, as they say, “elementary.”

The mystery: Your 30-day rehospitalization rate is higher than the national average (20.4%). Now onto the clues!

Clue One: Your rate is 25.6%. 

Clue Two: You deduce that, by day 10, your observed cumulative rehospitalization rate jumps to over 12% (national average 10.7%). What could be contributing? Is it Dr. Mustard on the skilled unit with a broken stethoscope? 

Clue Three: One-third of those who return to the hospital are diabetic. 

Clue Four: The diabetic patients arrive from the hospital with appropriate insulin coverage, and there are no issues with administering their medications in a timely manner. 

Clue Five: Most of these residents arrive on Thursday and Friday, but there is no pattern related to the time of day. 

Clue Six: Consulting with the dietary team confirms that the food provided to the residents is consistent with a well-managed diabetic diet. The investigation continues and another clue is discovered. 

Clue Seven: Most of the residents are rehospitalized on Sunday.

Clue Eight: The Saturday volunteer visits all new patients. When you follow that lead, you learn that part of the welcome to newcomers is a goody bag filled with cookies and chocolates.

You present your analysis to the IDT: The diabetic patients need “diabetic appropriate” gifts and the well-meaning volunteer needs some additional training. 

Well done, Sherlock! Mystery solved. Now share these clues with the QAPI team to ensure this system monitoring and root-cause analysis becomes a part of the daily workflow!


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