A new study aimed to examine factors in the discharge process that can be improved to reduce preventable hospital readmissions.
These readmissions negatively affect the health outcomes of patients and can lead to additional stress on family members and the already overburdened American health care system.
Patients discharged from the hospital after vascular surgeries are far more likely to be readmitted for a preventable matter than patients who return home after other types of surgeries.
Many vascular surgery patients have coexisting medical conditions, such as diabetes or high blood pressure, that can negatively affect surgical site infections, blood circulation, and wound healing, increasing their risk of complications and unplanned hospital readmissions.
To better understand the challenges related to the hospital discharge process that may influence unplanned readmissions, researchers interviewed nurses, physicians, patients, and health care staff about the obstacles they faced during the discharge process.
“Once we better understand the day-to-day challenges faced by the different stakeholders involved in the discharge process, we can work to improve it by identifying targeted interventions,” says Elizabeth Doss, a doctoral student at the University of Missouri’s Sinclair School of Nursing.
“As a nurse practitioner, I personally have felt the pressure to work quickly to discharge patients, but after listening to people’s experiences, it reminded me that we need to slow this part of the hospital process down to ensure families and patients have the information they need and that is makes sense to them.”
For the study, the team conducted focus group interviews with nurses, physicians, patients, and other health care staff involved in vascular surgeries at an acute care hospital in Missouri during the height of the COVID-19 pandemic.
They identified obstacles related to sending prescriptions; making follow up appointments; obtaining medications and wound care equipment; patient education regarding their diagnosis; and confusion regarding who to contact with follow-up questions or troubleshooting issues that arise at home.
Another common issue for nurses and hospital staff was a constant feeling of being rushed given the fast-paced work environment. This prevented nurses and staff from having enough time to communicate with their patients regarding appropriate discharge plans and protocols to ensure a safe and effective discharge process.
Also, visitor restrictions for family caregivers compounded these issues during the COVID-19 pandemic, given the critical role family caregivers often play in supporting patients during their recovery.
“Patients may struggle with contacting health care providers or not knowing who to call to ask for help,” Doss says. “After vascular surgeries, patients often go home with specialty wound care devices that can be tricky to set up, use and troubleshoot when issues or questions arise.
“Patients may not always remember what they were told immediately after the surgery when the discharge plans were being discussed. So, the challenge becomes how do we streamline these communication processes to ensure health care providers, patients, and their families are all on the same page.”
“Going forward, discharge coordinators and family caregivers can play a key role in supporting patients on their road to recovery,” Doss says. “Other options could include something such as a mobile phone application to help patients better communicate with their health care providers about questions or issues that might arise.”
The study appears in Research in Nursing & Health. The University of Missouri School of Medicine Translational Research Informing Useful and Meaningful Precision Health grant awarded to Todd Vogel.
Source: University of Missouri
