Do Postsurgical Follow-Up Calls Reduce Unplanned 30-Day Readmissions in Neurosurgery Patients? A Quality Improvement Project in a University Hospital.
Publication/Presentation Date
8-1-2024
Abstract
BACKGROUND: Unplanned 30-day readmissions after surgery are a source of patient dissatisfaction, monitored by the Centers for Medicare and Medicaid Services, have financial penalties for hospitals, and are publicly reported. Neurosurgical operations have a higher 30-day unplanned readmission rate after the index discharge than other specialties. After a simple initiative for a 48-72-hour postdischarge telephone call, there was an observed significant decrease in readmission rates from 17% to 8% in 7 months at Thomas Jefferson University. To better understand the role of postoperative telephone calls in this reduction, a retrospective evaluation over a longer period was performed.
METHODS: A quality improvement initiative was assessed using patient records between August 2018 and May 2023. The primary observed subject is the 30-day unplanned readmission rate and secondarily a change in Physician Communication Score. Thirty-day unplanned readmission rate and Physician Communication Scores before and after the telephone call initiative were compared, checking for difference, variance, and correlation.
RESULTS: 874 readmissions (average, 28/month; 95% confidence interval [CI], 25.3-29.3), 12.9% (95% CI, 11.9-13.9) were reported before the telephone call; of 673 readmissions (average, 26/month; 95% CI, 23-28.8), 12.9% (95% CI, 11.6-14.1) were reported after the telephone call. No significant difference, variance of scores or rates, or correlation of rate with communication score were noted before and after the initiative.
CONCLUSIONS: Telephone calls and peridischarge efficient communication are needed after neurologic surgery. This approach decreased unplanned readmissions in certain instances without having a significant impact on neurosurgical patients.
Volume
188
First Page
266
Last Page
275
ISSN
1878-8769
Published In/Presented At
Gebeyehu, T. F., Harrop, C. M., Barbieri, L., Thalheimer, S., & Harrop, J. (2024). Do Postsurgical Follow-Up Calls Reduce Unplanned 30-Day Readmissions in Neurosurgery Patients? A Quality Improvement Project in a University Hospital. World neurosurgery, 188, 266–275.e4. https://doi.org/10.1016/j.wneu.2024.05.078
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
38763460
Department(s)
Administration and Leadership
Document Type
Article