Restructuring Healthcare Delivery to Meet the Outpatient Ostomy Patient Needs: Strategies for Success

Post-operative complications occur in 71% of ileostomy and 43% of colostomy patients; providing the essential outpatient ostomy clinic service allows for the WOC nurse to continue education, provide regular assessments, interventions, address stoma-related problems, and avoid hospital re-admissions rates.¹ Improving patient access to the outpatient ostomy clinic in collaboration with surgical physician services, to enhance patient outcomes, decrease readmission rates and improve patient satisfaction.

Restructuring the healthcare delivery model was initiated after a thorough evaluation was completed to ascertain minimal pre-operative and post-operative ostomy patient visits related to the physical location and access to patient services. Failure of post-operative return patient visits, demonstrated a clear correlation with hospital re-admission rates, patient satisfaction, and post-operative complications.

Objective to achieve strategies of success outlined to relocate the physical outpatient ostomy setting from previous site and implementation of evidenced based outpatient guidelines. The new locale would be centrally located for surgical physician, laboratory, and pre-admission access. Patients would no longer have to travel more than 20 miles to receive each service. Stoma complications can occur at any time for the ostomate, 61% of ostomates followed for three months experienced peristomal moisture-associated skin damage²; regular interval examinations by the WOC nurse in the outpatient setting is imperative.

Outcomes from the professional practice change evidenced by a 300% increase in patient return visits in one year of site relocation and implementation of outpatient guidelines. Patient services became encompassing; one location allowed for imaging, laboratory, physician consult, ostomy consult, and pre-admission testing. The patient had access to view the hospital setting and meet with the in-patient ostomy team allowing for primary nursing care.