Surgical Patient Readmission Evidence-Based Prevention

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Table of Contents

Proposed Solution
Organizational Culture
Expected Outcomes
Method to Achieve Outcomes
Outcomes’ Impact
Conclusion
References

During a post-discharge period, surgical patients need assistance because of high risks of complications. As a result, there are also high risks of readmissions. In order to prevent readmissions, it is possible to implement an evidence-based intervention. The purpose of this paper is to propose the solution to the problem, analyze the organization’s culture, focus on expected outcomes, discuss methods to achieve these outcomes, and describe the outcomes’ impact on the quality of care.

Proposed Solution

To address the problem of high readmission levels for surgical patients aged between 21 and 75 years, it is necessary to propose an effective intervention: the policy according to which registered nurses (RNs), medical doctors (MDs), and nurse practitioners (NPs) should perform post-discharge telephone follow-up calls during thirty days after discharging a patient. This intervention is proved to be effective by Szöts, Konradsen, Solgaard, and Østergaard (2014), Clari et al. (2015), Daniels et al. (2016), Chen, Li, and Lin (2016), Lushaj et al. (2016), and Hornick, Balderman, Eugea, Sanchez, and Zayed (2016). Clari et al. (2015) and Daniels et al. (2016) have found that those patients who receive follow-up calls have fewer reasons to be readmitted to hospitals. Lushaj et al. (2016) have found that readmission levels decrease because follow-up calls contribute to minimizing risks for surgical patients. Researchers note that this intervention is appropriate to be implemented in many healthcare facilities.

Organizational Culture

The proposed solution can be discussed as efficient to be used in the selected organization. The hospital has all resources that are necessary in order to stimulate employees to adopt changes in a post-discharge procedure and realize the proposed intervention. RNs, MDs, and NPs are ready to perform follow-up calls to control outcomes for surgical patients, but more attention should be paid to the organization and management of the process. It is necessary to improve schedules of practitioners and set the time during which RNs, MDs, and NPs will be expected to perform follow-up calls and document possible complaints and comments provided by patients. The administration supports the project implementation and provides resources for organizing control and test groups in order to examine how the proposed intervention can influence the practice and readmission rates in the selected hospital.

Expected Outcomes

The proposed solution is oriented to achieving such outcomes as a significant reduction in the number of readmissions associated with surgical patients. It is expected that after six months of following the post-discharge procedure, it is possible to observe the reduction in readmission rates for patients who were provided with the nurses’ support with the help of follow-up calls in comparison to patients who did not receive such calls. The goal is to achieve the 70% reduction in readmissions in the selected hospital, and the result will be associated with the implemented intervention.

Method to Achieve Outcomes

In order to achieve the discussed outcomes, it is important to focus on the following activities:

To assign RNs, MDs, and NPs responsible for performing follow-up calls.
To develop a procedure for performing follow-up calls.
To revise the practitioners’ schedule and add time for performing calls.
To assess the readmission rate before the intervention.
To organize test and control groups.
To integrate the intervention.
To assess the results in both groups.
To draw conclusions regarding the outcomes.

Barriers that can prevent nurses from achieving outcomes are an ineffective schedule and the provision of an inappropriate questionnaire to assess the patients’ state. To address these barriers, it is necessary to evaluate results after the first month of implementing the intervention and revise the schedule and questionnaire if necessary.

Outcomes’ Impact

The discussed outcomes can have an impact on such areas as the quality of care and patient-centered care. It is possible to expect that the quality of the care will improve because healthcare providers will be able to address adverse effects as soon as possible. Furthermore, it will be possible to address patients’ complaints and control their state after discharging. Patients will receive the individual consultation and assistance, and this approach can contribute to reducing risks of complications for surgical patients when they are at home. As a result, it is possible to expect positive health outcomes for individuals.

Conclusion

The paper has provided the discussion of the proposed solution in the context of the organization’s culture. The expected outcomes and methods to achieve them are also discussed in detail. Much attention is paid to analyzing the impact of these outcomes on the quality of care.

References

Chen, M., Li, P., & Lin, F. (2016). Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty. Patient Preference and Adherence, 10(1), 257-264. Web.

Clari, M., Frigerio, S., Ricceri, F., Pici, A., Alvaro, R., & Dimonte, V. (2015). Follow‐up telephone calls to patients discharged after undergoing orthopaedic surgery: Double‐blind, randomized controlled trial of efficacy. Journal of Clinical Nursing, 24(19), 2736-2744. Web.

Daniels, S. A., Kelly, A., Bachand, D., Simeoni, E., Hall, C., Hofer, S. M., & Hayashi, A. (2016). Call to care: The impact of 24-hour postdischarge telephone follow-up in the treatment of surgical day care patients. The American Journal of Surgery, 211(5), 963-967. Web.

Hornick, J. R., Balderman, J. A., Eugea, R., Sanchez, L. A., & Zayed, M. A. (2016). A telephone call 1 week after hospitalization can identify risk factors for vascular surgery readmission. Journal of Vascular Surgery, 64(3), 719-725. Web.

Lushaj, E. B., Nelson, K., Amond, K., Kenny, E., Badami, A., & Anagnostopoulos, P. V. (2016). Timely post-discharge telephone follow-up is a useful tool in identifying post-discharge complications patients after congenital heart surgery. Pediatric Cardiology, 37(6), 1106-1110. Web.

Szöts, K., Konradsen, H., Solgaard, S., & Østergaard, B. (2014). Telephone follow-up by nurse following total knee arthroplasty-protocol for a randomized clinical trial. BMC Nursing, 13(1), 1-8. Web.

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