Date of Completion

5-16-2016

Embargo Period

5-11-2016

Keywords

Project RED (Re-Engineered Discharge), readmissions, transitions of care, falls, discharge planning, continuity of care, nurse practitioners, quality of care, Afaf Meleis, Theory of transition, Donabedian model of quality care

Major Advisor

Paula M. McCauley

Associate Advisor

Juliette M. Shellman

Associate Advisor

Thomas J. VanHoof

Field of Study

Nursing

Degree

Doctor of Nursing Practice

Open Access

Open Access

Abstract

Reducing readmissions has become a priority for hospitals across the country in an effort to improve care and to avoid financial penalties. The purpose of this pilot study is (a) to evaluate the impact of Project Re-Engineered discharge checklist on hospital readmissions within 30 days of discharge when compared to standard discharge instructions, (b) to evaluate adherence to the initial follow-up appointment with an outpatient provider in the trauma clinic within seven days of hospital discharge for fall patients compared to standard discharge instructions, and (c) to evaluate the impact insurance status, race, education, number of chronic illnesses present on admission, and planned post-discharge living arrangements on adherence to the initial follow-up appointment with an outpatient provider in the trauma clinic within seven days of discharge. Conducted between February 1, 2015 and October 1, 2015, this pilot study used a convenience sample (N = 50) of trauma patients admitted to a level II trauma center located in the Northeast. With respect to results, implementation of the Project Re-Engineered discharge checklist did not reduce readmissions (p = 0.247) or increase adherence to the initial follow-up appointment with an outpatient provider in the trauma clinic (p = 0.248). Demographics variables including age (p = 0.002) and race (p = 0.021) demonstrated statistical significance in reduced 30-day readmissions. Further research is needed to identify which modifications to the Project RED Discharge checklist might provide the greatest benefit to trauma patients in an effort to increase adherence to follow-up care, reduce readmissions and decrease healthcare costs.

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