Author : Denise Romney
Publisher :
ISBN 13 :
Total Pages : 90 pages
Book Rating : 4.:/5 (125 download)
Book Synopsis Transitional Telephone Follow-up Call by Nurse Practitioner by : Denise Romney
Download or read book Transitional Telephone Follow-up Call by Nurse Practitioner written by Denise Romney and published by . This book was released on 2019 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospital readmission is a severe problem, costing the United States $12 billion to $17.4 billion annually, with Medicare beneficiaries 65 years and older accounting for a disproportionate share of the cost. For 30 days post-discharge from hospitalization or an emergency department (ED) visit, the highest rates of readmission and ED revisits occur among patients suffering from a chronic obstructive pulmonary disease (COPD), heart failure, hypertension, or diabetes. In New York City, the problem of chronic illness and hospital readmissions is acute. For example, at a local hospital, the chronic disease population exceeds 20,000, the readmission rate is higher than 40%, and it takes 40 days to gain access to follow-up care. Research shows the Transitional Care Model Program (TCM) decreases readmission 30 days after the discharge of patients with chronic diseases, thereby reducing healthcare cost and improving health outcomes. Evidence-Based Framework: Rosswurm and Larrabee's Model for Change to Evidence-Based Practice and Meleis' Transitions Theory Model Framework guided the quality improvement practice change. Methods: The primary objective of the study was to determine whether transitional telephone follow-up (TFU) calls to patients with chronic diseases at primary adult care clinic reduce avoidable readmission and ED revisits 30 days post discharge. The TFU call intervention was implemented by a nurse practitioner using the Re-Engineered Discharge Project (RED) toolkit telephone script. TFU calls were conducted 1-14 days post-discharge from hospital stays or emergency department visits. The study employed a sample of 60 patients randomly assigned to one of two groups of 30 patients each. The treatmet group received TFU intervention, while the control group, was not subjected to intervention. Using the IBM SPSS program, the study employed Chi-square and Unpaired T-test statistics to compare the readmission and ED revisits of the control and treatment groups. Findings: The results show that TFU call intervention had a significant association with ED revisits. ED revisits among the treatment group were 30% less than that of the control group. In terms of number of visits, ED revists among the treatment group were 0.4 revisits less than that of the control group. By contrast, the results failed to establish a significant associatiion between the intervention and readmissions. Other results showed that the intervention reduced healthcare cost by ad estimated $554 per patient. Recommendations: The study recommends that the Transitional TFU call intervention is implemented as standard practice in the primary adult clinic at Kings County Medical Clinic for patients with chronic diseases.