- Karen Colorafi, PhD, RN, Doctoral Faculty, Providence/Gonzaga University Nurse Anesthesia Program, Spokane, WA
- Sheri Havel, DNP, FNP-C, CCRN, Hospitalist, Idaho Falls, ID
- Mirjeta Beqiri, PhD, Professor, School of Business Administration, Gonzaga University, Spokane, WA
Background/rationale: Across the U.S., 20% of cardiothoracic surgery patients discharged to home experience unplanned readmission within 30 days of discharge. Readmissions are often avoidable, associated with higher rates of mortality, increase healthcare costs, and lead to poor patient outcomes. Providing high quality, patient-centered education (regarding medications, follow-up appointments, coping strategies, wound and symptom management) by an interprofessional team is hypothesized to improve patient outcomes by facilitating patient and family engagement with post-surgical care plans, including appropriate follow-up with primary and mental health care. Description of population sampled: The dataset included 9,454 adult patients who underwent a cardiothoracic surgery between 2014 and 2020 at a large urban hospital in the Inland Northwest. The majority were male (63%, n= 5,953) and White (92%, n=8722), which accurately represents the lack of diversity within the general population where this study occurred. Study design: A retrospective, observational study design was utilized to evaluate the impact of patient education on 30-day readmission rates. Time series analysis produces the highest level of evidence in observational designs. Procedures and measures used: Data were first explored descriptively to assess variability and normalcy before performing a time series analysis to evaluate trends in readmission. The quarterly percent of cases were evaluated by time series analysis for trends. The total patient cases were also grouped by year, annual readmission rates were divided by the total annual cases to calculate the absolute annual percentage of readmissions for cardiothoracic surgery cases. Key Results: There was a 6% decrease (p<0.001) between average readmissions prior to and post program implementation. Patients with comorbidities were twice as likely to experience readmission than those with a low co-morbidity index [1.9 (1, .074), p =<.001]. Conclusions: A comprehensive program designed to improve patient and family engagement with post cardiothoracic surgical care plans was associated with a significant decrease in 30-day readmissions, emphasizing the importance of interprofessional and community based care.
- Describe the difference between forecasting and time series analysis.
- Discuss the impact of an interprofessional program of patient and family education on preventable 30-day readmission following cardiothoracic surgery.
- Describe the impact of comorbidities on 30-day readmissions following cardiothoracic surgery.