Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Carol Thompson

Clinical Mentor

Dr. Sarah Lester

Committee Member

Dr. Melanie Hardin-Pierce

Abstract

Aim and Objective: To determine if the implementation of a post-discharge call-back intervention for patients discharged home from the hospital after stroke was associated with a decrease in 30-day readmissions and improved patient satisfaction.

Background: Stroke is a leading cause of death and disability in the United States (American Stroke Association, 2015). Several studies have examined various post-discharge interventions, including a call to the patient and/or family after their return home, to determine the benefit to patients, if any (Zolfaghari, Mousavifar, Pedram & Haghani (2012). Understanding and anticipating patient needs and removing barriers post-stroke may decrease readmission rates as well as increase patient satisfaction with their hospital experience.

Design: A retrospective chart review examining pre-and post-intervention scores for patient satisfaction and 30-day readmissions for stroke patients who received post-discharge call backs from registered nurses (RNs).

Methods: The principal investigator gathered data points from the Stroke Coordinator to assess patient satisfaction utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. The principal investigator collected re-admission and demographic data from the Electronic Medical Record (EMR).

Findings: Overall pooled patient satisfaction scores improved from 73.6 percentile in the pre-intervention, to 78.8 percentile in the post-intervention. This number was not statistically significant, but an overall increase was nonetheless noted. Readmission rates declined slightly, 3.3% to 2.7 %, but again there was no statistical significance. Desired p-value was <0.05 for this quality improvement project.

Conclusion: Although not statistically significant, an overall improvement in patient satisfaction was noted, as well as an overall decrease in readmission rates, suggesting that a call-back intervention could benefit patients in their transition after stroke. Recommended future steps for this quality improvement project include creating stream-lined electronic data collection tools for call-backs to enable ongoing monitoring of compliance and further explore quality improvement measures.

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