Prevention of Ostomy Readmissions Post Surgery

Background/Problem:

Hospital readmission rates have emerged as a quality indicator by state, federal, and private payors with goals to deny payment for select readmissions. Readmission after colorectal surgery occurs frequently and costs approximately $9000 per readmission. Clinical and systems-based prevention strategies are needed to reduce readmissions. Readmission rates for ostomy-related concerns were seven (7) in 2012-2013.  There were additional twelve (12) patients who visited their primary physicians with new ostomy related complaints.

Purpose/Objective:

The purpose of this project was to determine best practice recommendations for reducing readmission rates of patients with ostomy-related complications.

Interventions:

An EBP project was conducted to determine evidence-based interventions that may help prevent patient readmissions and emergency center visits for ostomy-related complications.   Evidence based interventions to help improve patients’ learning were initiated. Best practice interventions that can support patients’ development of skills to safely navigate new health issues related to their newly created ostomy included: use of Language line/interpreter services; providing multiple 20-30 minute periods of ostomy education;  having family/friends of patient’s choice present when possible;  use of supplier’s access programs and literature; identifying ostomy community resources, and providing a list of durable medical suppliers, support groups, and validated internet sites.

Evaluation:

Before the project, the number of admissions from 2012-2013 was 7, with 12 additional patients visiting their primary physicians’ in the clinics with compliants.  The readmission rates post intervention has dropped to zero (0), along with emergency center visits.  There were five (3) patients with additional enquiries at the primary physician’s office related to complications stemming from changes in abdominal contour related to weight gain, weight loss or flushing of stoma after complete healing was achieved.

Conclusion:

Evidence-based interventions for patients with new ostomies can support full recovery with psychosocial adaptation and can reduce readmissions and EC visits for ostomy-related complications.