TY - JOUR
T1 - A Multipronged Intervention to Reduce Readmissions and Readmission Intensity After Radical Cystectomy
AU - Gul, Zeynep G.
AU - Wu, Shan
AU - Raver, Michael
AU - Vasan, Robin
AU - Mihalo, Jennifer
AU - Myrga, John M.
AU - Miller, David T.
AU - Pere, Maria P.
AU - Jones, Cameron A.
AU - Sharbaugh, Danielle R.
AU - Yabes, Jonathan G.
AU - Jacobs, Bruce L.
AU - Davies, Benjamin J.
N1 - Publisher Copyright:
© 2023
PY - 2023/12
Y1 - 2023/12
N2 - Objective: To develop a multipronged, evidence-based protocol to reduce readmission risk and readmission intensity, as represented by the duration of the index readmission, after radical cystectomy. Materials and Methods: A per-protocol study was performed. The protocol included preoperative nutritional supplementation, early stent removal, and a follow-up phone call within 4-5 days of discharge. The preprotocol period was from February 1, 2020 to July 31, 2021 and the postprotocol period was from December 1, 2020 to November 31, 2021. Using multivariate regression models, we compared outcomes among patients treated with radical cystectomy before and after protocol initiation. Results: We identified 70 preprotocol patients and 126 postprotocol patients. After adjusting for age, sex, BMI, and frailty score, there was a significant reduction in 90-day readmission intensity (7 vs 5 days; P = .048) among postprotocol patients. Conclusion: After implementation of an evidence-based protocol for patients undergoing radical 90-day readmission intensity decreased significantly. This protocol may move the needle forward on reducing readmissions, but a larger randomized trial is needed.
AB - Objective: To develop a multipronged, evidence-based protocol to reduce readmission risk and readmission intensity, as represented by the duration of the index readmission, after radical cystectomy. Materials and Methods: A per-protocol study was performed. The protocol included preoperative nutritional supplementation, early stent removal, and a follow-up phone call within 4-5 days of discharge. The preprotocol period was from February 1, 2020 to July 31, 2021 and the postprotocol period was from December 1, 2020 to November 31, 2021. Using multivariate regression models, we compared outcomes among patients treated with radical cystectomy before and after protocol initiation. Results: We identified 70 preprotocol patients and 126 postprotocol patients. After adjusting for age, sex, BMI, and frailty score, there was a significant reduction in 90-day readmission intensity (7 vs 5 days; P = .048) among postprotocol patients. Conclusion: After implementation of an evidence-based protocol for patients undergoing radical 90-day readmission intensity decreased significantly. This protocol may move the needle forward on reducing readmissions, but a larger randomized trial is needed.
UR - http://www.scopus.com/inward/record.url?scp=85173678134&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2023.08.012
DO - 10.1016/j.urology.2023.08.012
M3 - Article
C2 - 37666330
AN - SCOPUS:85173678134
SN - 0090-4295
VL - 182
SP - 155
EP - 160
JO - Urology
JF - Urology
ER -