St. James Hospital is a small commercial geriatric hospital serving elderly patients with chronic illness, injury, and aging symptoms. The hospital does not have an oncology and psychiatric department. The hospital has 80 beds and a small staff of nurses, physicians, surgeons, anesthesiologists, and other specialists who are required to serve the patients. However, while there are enough doctors to perform operations and prescribe treatments, the hospital faces a shortage of nurses who can care for patients. This disadvantage is felt especially acutely, since elderly patients are often unable to move independently and take care of themselves; thus, they need constant care and support.
The main problem of the hospital is the re-admission of patients less than 30 days after discharge. According to the Hospital Readmission Reduction Program, frequent patient re-admissions are a reason for funding cuts, which in the small St. James hospital’s case leads to a lack of funds and an even greater shortage of staff. However, patients’ and their caregivers’ education, as well as follow-up calls and nursing visits to patients after discharge, reduce the likelihood of re-admission by 50% (Vernon et al., 2019; Coffey et al., 2019). Follow-up calls and checks allow nurses to propose changes in treatment on time that prevent health deterioration.
Hence, the main goal for St. James is to reduce re-admission by 50%, which includes such objectives as improving patient education and creating a system and schedule for nurses’ follow-up call patients and review of their health condition.
The goal of reducing patient re-admission is long-term as it takes time to implement and evaluate results. For this reason, the deadline for a 50% reduction in patient re-administration within 30 days after discharge is twelve months. In addition, the hospital will conduct interim assessments after six and nine months of project implementation start. Developing of nurses’ follow-up call system should take no more than one month, as well as scheduling for additional patient education. This period is necessary to agree and coordinate the working hours of nurses and other staff and determine the payment system for extra hours of work. However, a 20% improvement in patient education will be achieved in 3 months. The evaluation will be carried out by interviewing patients upon admission and after discharge.
This project requires almost no material costs, but a significant part of the budget must be spent on paying additional working hours for nurses. Some of the extra time will be spent on calls and some on patient education. In addition, funds could be spent on hiring one or two staff members who provide education to patients, since this decision can reduce other nurses’ working hours. Thus, the project will be built in-house, since all the goals set are within the competence of the nurses, although they are limited in time.
This approach will also reduce costs, which is necessary with a limited budget of St. James Hospital. Responsible for organizing the project will be Mr. Coal, Senior Healthcare Manager, who will coordinate physicians and nurses, identify means of communication with discharged patients, assess progress, and decide on recruiting additional staff. Ms. Violet, Senior Nurse Manager, will be responsible for scheduling and organizing nurses. Other nurses will be responsible for patient care and their direct responsibilities. Thus, all staff will be involved in implementing the project, since coordination and time planning are key for a small hospital with limited resources.
References
Coffey, A., Leahy-Warren, P., Savage, E., Hegarty, J., Cornally, N., Day, M. R., Sahm, L., O’Connor, K., O’Doherty, J., Liew, A., Sezgin, D., & O’Caoimh, R. (2019). Interventions to promote early discharge and avoid inappropriate hospital (re)admission: A systematic review. International Journal of Environmental Eesearch and Public Health, 16(14), 2457. Web.
Vernon, D., Brown, J. E., Griffiths, E., Nevill, A. M., & Pinkney, M. (2019). Reducing readmission rates through a discharge follow-up service. Future Healthcare Journal, 6(2), 114–117. Web.