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Improved outcomes following the implementation of a decompensated cirrhosis discharge bundle

Katherine Smethurst1, Jennifer Gallacher1, Laura Jopson1

  • 1Liver Unit, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.

Frontline Gastroenterology
|September 1, 2022
PubMed

Insights

A new care bundle for decompensated cirrhosis (DC) patients improved care consistency and reduced hospital readmissions. This standardized approach to managing DC patients shows promise for better patient outcomes and reduced healthcare variability.

Area of Science:

  • Hepatology
  • Clinical Management
  • Healthcare Quality Improvement

Background:

  • Mortality from liver disease is rising, with inconsistent management of decompensated cirrhosis (DC) in the UK.
  • Patients with DC require complex care post-discharge, leading to frequent early readmissions.

Purpose of the Study:

  • To develop a Decompensated Cirrhosis Discharge Bundle (DCDB) to optimize patient care.
  • To evaluate the impact of implementing the DCDB on patient management and outcomes.

Main Methods:

  • A baseline review of DC patient management was conducted in 2017.
  • The DCDB was developed and implemented, with impact assessed in two phases: paper (2018-2019) and electronic (2020-2021).
  • Key clinical data were collected from patient discharge through three review cycles.

Main Results:

  • Baseline care was suboptimal, with 12% of patients experiencing potentially avoidable 30-day readmissions.
  • Post-DCDB implementation, improvements were noted in electrolyte monitoring and community alcohol follow-up.
  • Potentially preventable readmissions decreased to 5% after the bundle's introduction.

Conclusions:

  • A standardized care bundle for DC patients can improve management and outcomes.
  • Wider adoption of the DCDB could reduce care variability and enhance patient recovery.
  • The study highlights the effectiveness of structured discharge planning in managing complex liver disease patients.
Abstract

Keywords:
alcoholascitescirrhosisencephalopathyliver

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