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A Quality Improvement Initiative: A Nurse Practitioner-Led Interdisciplinary Approach to Reducing Readmissions in the
Clare Rovito1, Kathleen Fagan2
1Felician University, Lodi, New Jersey rcrovito@aol.com fagank@felician.edu.
Background:
To decrease the 30-day Subacute Readmissions in an outpatient facility by using an Advanced Practice Nurse (APN) Project Leader while applying evidence based transitional care processes.
Objective:
Determine the effects of APN leadership within the Interdisciplinary Team in the subacute setting.
Methods:
Immersion of an APN as Project Leader over a 12-week period.
Results:
Outcomes were divided into three groups. They were reorganized and analyzed. The new breakdown included patients readmitted plus hospice referrals (n = 5) and those not readmitted (n = 4). A significant difference in the 30-day outcomes as well as the LACE variable comorbidity scores t (4) = 2.95, p = 0.0418 were identified.
Conclusions:
The 30-day readmission rates were decreased using hospice as a referral source. Application of the Lippitt's Model of Planned Change and the use of the LACE Scoring Tool were instrumental to the success of this project.
Implications For Nursing:
To improve optimal outcomes it is necessary for the APN/Doctor of Nursing Practice (DNP) and other healthcare professionals to engage in collaborative practices that result in effective policy changes. This quality improvement project restructured the existing Interdisciplinary Team processes to include the APN Project Leader with improved patient-centered outcomes.
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