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Improve Readmissions And Patient Satisfaction Scores With A Revised Discharge Education Plan, Michele M. Hughes

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Problem: Payers of health insurance are tracking key performance measures and are limiting payments to hospitals. With this threat to financial reimbursement hospital systems have increased emphasis on tracking and improving outcomes. The purpose of this project is to reduce all-cause 30-day readmissions and improve patient satisfaction scores in the care transitions domain after a total hip or total knee replacement by revising the discharge materials and education.

Method: The total joint replacement discharge education materials were revised to address the common causes of readmissions. The documents were reformatted to improve literacy level, readability, and patient learning. Nurses were educated …

Discharge By 11:00 Am And The Effects On Throughput, Gena Bravo

Master's Projects and Capstones

This Clinical Nurse Leader project aims to improve the discharge process to increase the percentage of patients discharged before 11:00 AM on the Progressive Care Unit (PCU). One evidence-based approach to help alleviate capacity constraints in the hospital is to create an effective and timely discharge process. The goal of this project is to educate the front line staff, care coordinators, and providers to a standardized discharge process. The PCU is a cardiac telemetry unit with 30 private rooms. The patients on the PCU are post-cardiac surgery with some overflow medical patients throughout the unit. Kotter’s theoretical framework was chosen …

A Roadmap For The Journey Home - A Supplemental Tool Guiding Patients From Hospital To Home, Michelle Basco

Master's Projects and Capstones

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Enhancing Discharge Transitions At Gifford Health Care, Megan L. O'Brien

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Enhancing Discharge Transitions at Gifford Health Care

Megan L. O’Brien, MS, FNP-BC, APRN

Purpose. During transitions of hospital discharge, errors and lack of education pose risks to patients resulting in dissatisfaction with hospital care, poorly attended follow-up appointments, and readmissions. Discharge planning that encompasses patient centered, multidisciplinary principles have been proven to reduce health care costs while increasing satisfaction among patients and staff. At Gifford Health Care in Randolph, Vermont, hospital readmission rates were below the national average of 15.9%, but the patient satisfaction scores were lower than state and national averages. To improve discharge transitions, this project utilized the …

Care Coordination For Better Outcomes, Chad Dunavan

Walden Dissertations and Doctoral Studies

A deficiency of care coordination and delayed discharge planning has contributed to increased lengths of stay for telemetry patients and has pressed staff to discharge patients expeditiously, potentially leading to increased 30-day readmissions. Rushing the discharge process on the day of discharge has resulted in breakdowns in communication and lack of collaboration amongst the health care team of this study, contributing to extended lengths of stay, increased readmissions, and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. This project highlighted a patient-centered care coordination team approach with 2 clinical registered nurses and a social worker who coordinated …