TY - JOUR
T1 - Improved Outpatient Communication Decreases Unplanned Readmission in Necrotizing Pancreatitis
AU - Maatman, Thomas K.
AU - McGreevy, Kathleen A.
AU - Sood, Andrew J.
AU - Ceppa, Eugene P.
AU - House, Michael G.
AU - Nakeeb, Attila
AU - Schmidt, C. Maximilian
AU - Nguyen, Trang K.
AU - Zyromski, Nicholas J.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Background: Unplanned readmission rates in necrotizing pancreatitis (NP) are among the highest of any medical disease (72%). Recent work has identified several potentially preventable causes of unplanned readmission in NP. We hypothesized that intensive outpatient communication would identify developing problems and decrease unplanned hospital readmission. Materials and methods: A review of NP patients treated at a single institution between 2016 and 2019 compared patients 2 y before (NP-pre, 2016-2018) and 1 y after (NP-post, 2018-2019) the establishment of a dedicated pancreatitis nurse coordinator. Unplanned hospital readmission and emergency room visits were compared between groups. Results: A total of 178 NP patients were treated—112 patients in the NP-pre group and 66 patients in the NP-post group. No differences between groups were observed in age, sex, comorbidities, pancreatitis etiology, NP severity, or mortality. A mean of 5.4 ± 0.2 outpatient communications per patient with the pancreatitis nurse coordinator was documented in the NP-post group. Unplanned readmission rates decreased significantly from 64% (NP-pre) to 45% (NP-post; P = 0.02). The frequency of readmission decreased from 1.6 readmissions per patient (NP-pre) to 0.8 readmissions per patient (NP-post; P = 0.001). Readmissions because of symptomatic necrosis, failure to thrive, nonnecrosis infection, and drain dysfunction decreased (P < 0.05). Overall disease duration was similar (NP-pre, 4.6 ± 0.3 mo; NP-post, 5.0 ± 0.3 mo; P = 0.4); however, the mean number of unplanned inpatient days decreased from 15.4 ± 2.2 d (NP-pre) to 7.8 ± 1.6 d (NP-post; P = 0.02). Conclusions: Improved outpatient communication identifies treatable problems and significantly decreases unplanned readmission in NP patients.
AB - Background: Unplanned readmission rates in necrotizing pancreatitis (NP) are among the highest of any medical disease (72%). Recent work has identified several potentially preventable causes of unplanned readmission in NP. We hypothesized that intensive outpatient communication would identify developing problems and decrease unplanned hospital readmission. Materials and methods: A review of NP patients treated at a single institution between 2016 and 2019 compared patients 2 y before (NP-pre, 2016-2018) and 1 y after (NP-post, 2018-2019) the establishment of a dedicated pancreatitis nurse coordinator. Unplanned hospital readmission and emergency room visits were compared between groups. Results: A total of 178 NP patients were treated—112 patients in the NP-pre group and 66 patients in the NP-post group. No differences between groups were observed in age, sex, comorbidities, pancreatitis etiology, NP severity, or mortality. A mean of 5.4 ± 0.2 outpatient communications per patient with the pancreatitis nurse coordinator was documented in the NP-post group. Unplanned readmission rates decreased significantly from 64% (NP-pre) to 45% (NP-post; P = 0.02). The frequency of readmission decreased from 1.6 readmissions per patient (NP-pre) to 0.8 readmissions per patient (NP-post; P = 0.001). Readmissions because of symptomatic necrosis, failure to thrive, nonnecrosis infection, and drain dysfunction decreased (P < 0.05). Overall disease duration was similar (NP-pre, 4.6 ± 0.3 mo; NP-post, 5.0 ± 0.3 mo; P = 0.4); however, the mean number of unplanned inpatient days decreased from 15.4 ± 2.2 d (NP-pre) to 7.8 ± 1.6 d (NP-post; P = 0.02). Conclusions: Improved outpatient communication identifies treatable problems and significantly decreases unplanned readmission in NP patients.
KW - Acute necrotizing
KW - Continuity of patient care
KW - Cost savings
KW - Pancreatitis
KW - Patient care team
KW - Patient readmission
KW - Patient satisfaction
UR - http://www.scopus.com/inward/record.url?scp=85083644143&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2020.03.034
DO - 10.1016/j.jss.2020.03.034
M3 - Article
C2 - 32353639
AN - SCOPUS:85083644143
SN - 0022-4804
VL - 253
SP - 139
EP - 146
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -