Enhancing Continuity of Care in a Complex Patient Population: Collaboration Model between an Acute Care and Subacute Care CNS

2.50
Hdl Handle:
http://hdl.handle.net/10755/164057
Category:
Abstract
Type:
Presentation
Title:
Enhancing Continuity of Care in a Complex Patient Population: Collaboration Model between an Acute Care and Subacute Care CNS
Author(s):
Tripepi-Bova, Kathy; Salamon, Lisa
Author Details:
Kathy Tripepi-Bova, RN, MSN, CCRN, CCNS, Cleveland Clinic Foundation, Cleveland, Ohio, USA, email: nacnsorg@nacns.org; Lisa Salamon, MSN, CNS, RNBC, ETN
Abstract:
Problem and Significance: Esophagectomy surgery patients are a complex patient population whose comorbid conditions may require extended care in the subacute care setting before their discharge home. Coordination of care is necessary in order to optimize care, reinforce education, assist in the transition to the subacute and home settings, and prevent readmission back to the acute care hospital. A collaborative practice model was established with a thoracic acute care CNS and a subacute CNS at an affiliate subacute facility in a large Midwest teaching hospital. Purpose/Research Questions: The purpose of this project is to describe the role of the CNS in both the acute and subacute settings. The purpose is also to determine if the collaborative process is effective in decreasing length of stay (LOS) in the acute and subacute setting and effective in decreasing the readmission rate back to the acute care hospital. Method: A retrospective chart review of esophageal surgeries and subacute admissions was done for 2001 and 2002 looking at LOS in both acute care and subacute care. Readmission from the subacute facility back to the acute care hospital was also reviewed. Results: In 2001 and in 2002, 105 and 131 esophageal surgeries were done respectively in a large Midwest teaching hospital. Of those 105 patients with surgeries done in 2001, 23 required admission into an affiliate subacute facility for further care. Six of these patients were readmitted back to the hospital for a readmission rate of 24%. Length of stay (LOS) in the acute care for these patients initially was 17 days and LOS at the subacute facility was 4 days. In 2002, 30 patients were admitted to the subacute facility after recovery from their esophageal surgery. Eight of these patients required readmission into the acute care setting for a readmission rate of 24%. Length of stay initially in the acute care for these patients was 14 days and LOS at the subacute facility was 10 days. Findings and Conclusions: Although the readmission rate remained essentially the same in both 2001 and 2002 there was a 77% increase in the number admissions to the subacute facility in 2002 as compared to 2001. Length of stay for the acute care was reduced by 3 days from 2001 to 2002 and in subacute care the LOS was reduced by 1 day. Coordination of care by a CNS in the acute and subacute arena assisted in decreasing LOS for both acute and subacute settings and maintained the readmission rate at a constant level despite an increase in subacute admissions. Implications for Nursing Practice: Providing concurrent monitoring of patient progress by both the acute care and subacute care CNS's, establishes earlier dialog regarding patient specific requirements for discharge home It also provides earlier interventions when problems arise in the subacute setting. A contact person in the subacute care setting allows patients and families to dialog with an onsite person who is familiar with this complex patient population and who can facilitate getting answers quickly. The acute care CNS provides immediate contact, information and feedback in this complex patient population.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Century
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
San Antonio, Texas, USA
Description:
Conference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEnhancing Continuity of Care in a Complex Patient Population: Collaboration Model between an Acute Care and Subacute Care CNSen_GB
dc.contributor.authorTripepi-Bova, Kathyen_US
dc.contributor.authorSalamon, Lisaen_US
dc.author.detailsKathy Tripepi-Bova, RN, MSN, CCRN, CCNS, Cleveland Clinic Foundation, Cleveland, Ohio, USA, email: nacnsorg@nacns.org; Lisa Salamon, MSN, CNS, RNBC, ETNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164057-
dc.description.abstractProblem and Significance: Esophagectomy surgery patients are a complex patient population whose comorbid conditions may require extended care in the subacute care setting before their discharge home. Coordination of care is necessary in order to optimize care, reinforce education, assist in the transition to the subacute and home settings, and prevent readmission back to the acute care hospital. A collaborative practice model was established with a thoracic acute care CNS and a subacute CNS at an affiliate subacute facility in a large Midwest teaching hospital. Purpose/Research Questions: The purpose of this project is to describe the role of the CNS in both the acute and subacute settings. The purpose is also to determine if the collaborative process is effective in decreasing length of stay (LOS) in the acute and subacute setting and effective in decreasing the readmission rate back to the acute care hospital. Method: A retrospective chart review of esophageal surgeries and subacute admissions was done for 2001 and 2002 looking at LOS in both acute care and subacute care. Readmission from the subacute facility back to the acute care hospital was also reviewed. Results: In 2001 and in 2002, 105 and 131 esophageal surgeries were done respectively in a large Midwest teaching hospital. Of those 105 patients with surgeries done in 2001, 23 required admission into an affiliate subacute facility for further care. Six of these patients were readmitted back to the hospital for a readmission rate of 24%. Length of stay (LOS) in the acute care for these patients initially was 17 days and LOS at the subacute facility was 4 days. In 2002, 30 patients were admitted to the subacute facility after recovery from their esophageal surgery. Eight of these patients required readmission into the acute care setting for a readmission rate of 24%. Length of stay initially in the acute care for these patients was 14 days and LOS at the subacute facility was 10 days. Findings and Conclusions: Although the readmission rate remained essentially the same in both 2001 and 2002 there was a 77% increase in the number admissions to the subacute facility in 2002 as compared to 2001. Length of stay for the acute care was reduced by 3 days from 2001 to 2002 and in subacute care the LOS was reduced by 1 day. Coordination of care by a CNS in the acute and subacute arena assisted in decreasing LOS for both acute and subacute settings and maintained the readmission rate at a constant level despite an increase in subacute admissions. Implications for Nursing Practice: Providing concurrent monitoring of patient progress by both the acute care and subacute care CNS's, establishes earlier dialog regarding patient specific requirements for discharge home It also provides earlier interventions when problems arise in the subacute setting. A contact person in the subacute care setting allows patients and families to dialog with an onsite person who is familiar with this complex patient population and who can facilitate getting answers quickly. The acute care CNS provides immediate contact, information and feedback in this complex patient population.en_GB
dc.date.available2011-10-27T11:41:12Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:12Z-
dc.conference.date2004en_US
dc.conference.name2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Centuryen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.descriptionConference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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