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While discussing the experiences of surgical patients, it is important to note that the problem of high rates related to readmissions is typical of many healthcare facilities. To discuss this problem in detail and propose an effective solution, it is necessary to refer to the evidence-based practice in this field. The purpose of this paper is to provide the background of the problem, describe stakeholders, present a PICOT question, focus on the purpose and objectives of the project, and explain the importance of the problem.
Background of the Problem
Readmissions and hospitalizations of surgical patients are typical situations that are associated with ineffective post-discharge procedures. The risk of adverse effects is high when patients and their relatives do not receive enough education regarding the care and procedures that should be proposed after discharging surgical patients. Even if patients and their families are educated regarding the expected risks, adverse effects, and strategies to overcome them, they often need professional support (Crocker, Crocker, & Greenwald, 2012). When patients do not receive the appropriate support during a post-charge period, the risk of readmission can increase. As a result, rates of readmissions are typically high for surgical patients if they do not receive adequate follow-up care (Hoffman & Pelosini, 2016). The problem is in the fact that readmissions are costly not only for patients but also for healthcare providers. The reason is that many healthcare resources are necessary to deliver effective care and prevent further complications in patients.
Stakeholders and Change Agents
To address the determined problem, it is important to propose such intervention as the use of post-discharge telephone follow-up calls to exchange the information, support surgical patients, and recognize possible complications. This intervention can affect patients and their families, registered nurses (RNs), medical doctors (MDs), nurse practitioners (NPs), and administrators in healthcare facilities as stakeholders. Patients can benefit from this proposal because of opportunities to receive aftercare support and advice. Advantages for healthcare professionals and administrators include saving resources and improving post-discharge procedures (Daniels et al., 2016). As a result, the rate of readmissions can decrease, as well as costs associated with hospitalizations. In this case, administrators and nurse leaders in hospitals are expected to act as change agents who focus on implementing the post-discharge follow-up procedure.
In surgical patients aged 21-75 years, will a 24/48-hour post-discharge telephone follow-up performed by an RN/MD/NP and compared to no call reduce the rate of hospital readmissions within 30 days over six months?
Purpose and Objectives
The purpose of this project is to find out whether post-discharge telephone follow-up calls performed by an RN, MD, or NP can contribute to reducing the rate of readmissions for surgical patients with the focus on providing a follow-up during 30 days and studying the results during six months. The objectives can be formulated in the following way:
- By the end of the first month, to develop and integrate the post-discharge follow-up procedure based on telephone calls performed by an RN/MD/NP.
- By the end of six months, to achieve the reduction in readmission rates by 70% for those surgical patients who receive post-discharge follow-up calls in comparison to patients who do not receive such calls.
Before implementing the procedure, it is necessary to measure readmission rates in the selected hospital, organize surgical patients in two groups, and conduct the evaluation after the intervention in order to state whether the 70% reduction in readmissions is observed for the test group of patients.
The rationale to Focus on the Problem
The problem of surgical patients’ readmissions requires a solution because of financial and administrative barriers associated with high rates of such hospitalizations. According to Lushaj et al. (2016), 1 in 5 patients can be readmitted to hospitals because of health problems and adverse effects of inappropriate post-discharge strategies. Therefore, it is important to address the problem of post-discharge care and support that are provided to surgical patients (Daniels et al., 2016). If patients have no access to the medical staff after being discharged, risks of further problems and readmissions increase (Leppin et al., 2014). Follow-up calls can be viewed as effective methods to address the problem and reduce readmissions and associated expenses (Hoffman & Pelosini, 2016). Thus, the problem needs a resolution to improve patient outcomes.
This part of the project presents the problem description and associated objectives. Additionally, the rationale for resolving the issue is also provided. The project is based on recent literature related to the problem of post-discharge procedures and readmissions.
Crocker, J. B., Crocker, J. T., & Greenwald, J. L. (2012). Telephone follow-up as a primary care intervention for postdischarge outcomes improvement: A systematic review. The American Journal of Medicine, 125(9), 915-921. 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.
Hoffman, J. J., & Pelosini, L. (2016). Telephone follow-up for cataract surgery: Feasibility and patient satisfaction study. International Journal of Health Care Quality Assurance, 29(4), 407-416. Web.
Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K.,… & Ting, H. H. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. 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.