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Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

ContributorsAnnor, Wilhelmina Sagoe (Author) / Baker, Laurie (Thesis advisor)
Created2020-05-05
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Importance: Idiopathic Pulmonary Fibrosis (IPF) is a worldwide deadly disease with a mortality rate of nearly 100% without lung transplantation (IPF Foundation, 2020). The exact cause of this disease is unclear. Evidence has shown that IPF patients have a high risk of having abnormal acid reflux. Chronic acid reflux can

Importance: Idiopathic Pulmonary Fibrosis (IPF) is a worldwide deadly disease with a mortality rate of nearly 100% without lung transplantation (IPF Foundation, 2020). The exact cause of this disease is unclear. Evidence has shown that IPF patients have a high risk of having abnormal acid reflux. Chronic acid reflux can worsen IPF prognosis. Objective: To assess the effectiveness of an online educational intervention in enhancing clinician’s belief, confidence and readiness in implementing an acid reflux screening protocol in IPF patients. Methods: Physicians and nurse practitioners in primary care and pulmonary specialties within the United States were asked to complete online pre- and post-surveys after reviewing a webpage presenting up-to-date research evidence showing the relationship between IPF and gastroesophageal reflux disease (GERD). Main Outcomes and Measures: Questionnaires adapted from the Evidence-Based Practice Beliefs and Implementation Scales by Melnyk were utilized to evaluate changes in belief, confidence and readiness to implement evidence-based practice recommendations. Results: Percentage of participants who strongly believed in acid reflux screening in IPF increased from 60% pre-survey to 80% post survey (M=4.75, SD=0.58). The percentage of participants who thought they were ready to implement this screening protocol decreased from 60% pre-survey to 50% post survey (M=4.44, SD=0.63). More participants felt strongly confident during the post-survey. The pre-survey had 130 views with a completion rate of 12.3%. Conclusion and Relevance: An online educational tool such as a webpage was an effective way to enhance clinician’s belief and confidence in acid reflux screening in IPF. Keywords: idiopathic pulmonary fibrosis, gastroesophageal reflux disease, abnormal acid reflux screening, evidence-based practice
Created2021-04-27
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Low back pain is a worldwide health problem. Preoperative education is essential to provide patients with information across the continuum of care. Gaps exist among healthcare organizations regarding deficiencies in properly educating patients about their surgical experience. The lack of proper preoperative education can negatively impact reimbursement for healthcare systems,

Low back pain is a worldwide health problem. Preoperative education is essential to provide patients with information across the continuum of care. Gaps exist among healthcare organizations regarding deficiencies in properly educating patients about their surgical experience. The lack of proper preoperative education can negatively impact reimbursement for healthcare systems, providers, and patient outcomes. In a large metropolitan tertiary care center providing spine surgery, an evidence-based project was implemented. A self-developed pre and post intervention surveys was given assessing patients’ knowledge and surgical expectations after surgery. A tri-fold education pamphlet was given to the participants with information that included detailed information regarding expectations before and after surgery.

Descriptive statistics were used to describe the sample and outcome variable. An increase in knowledge in expectations after surgery was noted from pre-intervention (mean 1.83, SD .408) to post-intervention (mean 1.67, SD .816) with a Cohen’s D of 0.248 although this was not statistically significant. However, the change in average length of stay (LOS) was significant. The average LOS for the project participants dropped from 4.54 days to 2.833 days which is within the Centers for Medicare and Medicaid Services (CMS) guidelines of 2.92 days for this surgical population. In conclusion, an increased in patients’ knowledge regarding expectations following surgery and decreased LOS was seen for the project participants.

ContributorsTrejo, Anna Janet (Author) / Baker, Laurie (Thesis advisor)
Created2019-05-03