Decreasing Readmissions After Ileostomy Creation Through a Perioperative Quality Improvement Program.

Area of Science:

• Colorectal Surgery
• Surgical Quality Improvement
• Patient Outcomes

Background:

• Ileostomy creation following colorectal surgery is associated with high 30-day readmission rates (up to 40%).
• These readmissions impose a substantial burden on healthcare costs and patient quality of care.
• Reducing readmissions is a critical goal for improving surgical patient management.

Purpose of the Study:

• To evaluate the effectiveness of a perioperative quality improvement program designed to decrease readmissions after ileostomy creation.
• To assess the program's impact on overall readmission rates and specific causes of readmission, such as dehydration.

Main Methods:

• Implementation of a perioperative quality improvement program involving specific interventions for patients undergoing ileostomy creation.
• Prospective enrollment of 80 patients at a single tertiary care academic center from February 2020 to January 2021.
• Comparison of 30-day readmission rates and causes with historical national database data using descriptive statistics.

Main Results:

• The program achieved an overall 30-day readmission rate of 8.75%, significantly lower than the historical cohort rate of 20.10% (p = 0.01).
• Dehydration was a cause for readmission in 3.75% of patients.
• Urgent or emergent operative status was identified as the most significant risk factor for all-cause readmission (p = 0.01).

Conclusions:

• The implemented quality improvement program successfully reduced all-cause 30-day readmission rates after ileostomy creation.
• The program also demonstrated success in decreasing readmissions specifically due to dehydration.
• These findings highlight the program's effectiveness within an academic tertiary care setting and in comparison to historical data.