Reducing Hospital Readmissions Due to Dehydration after Colorectal Surgery

An analysis of colorectal readmissions revealed that dehydration was a frequent cause of readmission after major colorectal surgery. Patients who had an ileostomy creation were at the greatest risk. Our objective was to reduce readmissions due to dehydration by 50%.        Method: An interprofessional Colorectal Quality Improvement Team was established to reduce readmissions due to dehydration. This group met twice per month. The participants represented clinicians from across the continuum of care and uncovered many inconsistencies and gaps in patient education. One area of focus was teaching patients how to measure fluid intake and stool output at home after discharge. A daily work sheet to track this activity was developed. Patients were taught specific interventions to follow based upon the data collected.  Education was provided before surgery by the Certified Wound and Ostomy Care Nurses at the preoperative appointment. The education was reinforced throughout the inpatient stay by the bedside nurse, clinical educator, and the visiting nurse at the patient’s home. Hospital readmissions were followed and data tracked.                                                                                                                                                                                                                                                                                                        Results: Since implementation of the education program, one patient was seen in the emergency department and only one patient needed to be admitted to the hospital.                                                                                                                                   Conclusions: Consistent patient education across the continuum of care has been successful in decreasing readmissions related to dehydration.                                                                                                                                                                                 Clinical Implications: Consistent patient education from the preoperative visit, during the inpatient stay, and reinforced at home has been shown to reduce hospital readmissions due to dehydration.  Decreasing readmissions improves the patient experience as well as decreases healthcare costs.