Multidisciplinary protocol to reduce surgical readmissions in Australia: American College of Surgeons National Surgical Quality Improvement Program

Helen Pham, Kerry Hitos, Rishan Pawaskar, Jane-Louise Sinclair, Hazel Mathuthu, Christopher B. Nahm, Tony Pang, Vincent Lam, Arthur Richardson

Research output: Contribution to journalArticlepeer-review

Abstract

IntroductionUnplanned readmissions in general surgery are an important quality indicator of patient care and are associated with increased costs to healthcare services. This study aims to implement a multidisciplinary protocol in a single institution in a tertiary referral hospital to monitor and reduce unplanned readmission rates.MethodsA prospective cohort study using an institution-based protocol was conducted over an 18-month period including patients undergoing a general surgical procedure. The protocol included: (i) implementation of a surgical readmissions nurse-patient liaison; (ii) access to a surgical walk-in clinic; and (iii) early post-discharge phone contact. Data included demographic details, index procedure, hospital length of stay (LOS), and whether contact between patient/nurse occurred upon discharge. The primary outcome was the cause and rate of 30-day readmissions. Secondary outcomes were mortality, use of surgical clinic, emergency department presentations, and complications.ResultsAfter protocol implementation, 874 patients underwent a general surgical procedure, with 354 (49%) being male and an overall median age of 53.0 years (interquartile range: 36.0-67.0). The overall readmission rate was 5.6% (n = 49), with a median LOS after readmission of 4 days. Compared with historical pre-protocol ACS-NSQIP data, this reflects a 30% reduction compared to that of readmission rate of 7.9%, P = 0.03.ConclusionThe multidisciplinary protocol was efficacious in significantly reducing unplanned readmissions. Continued audits and monitoring of factors associated with readmissions are required to help design targeted projects that may lead to improved outcomes, lower costs, increased patient satisfaction, and better efficiency within our healthcare system.Implementation of multidisclipinary protocol is effective in reducing unplanned general surgical readmissions. This study highlights the need for continued review of unplanned readmissions and adjustment of targeted interventions that are designed to improve patient outcomes and lower hospital costs.image
Original languageEnglish
Number of pages7
JournalANZ Journal of Surgery
DOIs
Publication statusE-pub ahead of print - 21 Oct 2024

Keywords

  • Multidisciplinary
  • Quality improvement
  • Readmissions

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