Do Post-Surgical Follow-Up Calls Reduce Unplanned 30-day Readmissions in Neurosurgery Patients? A Quality Improvement Project in a University Hospital

Unplanned 30-day readmissions after surgery are a source of patient dissatisfaction, monitored by the Centers for Medicare and Medicaid Services, have financial penalties for hospitals and are publicly reported. Neurosurgical operations unfortunately have a higher 30-day unplanned readmission rate a...

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Bibliographic Details
Published inWorld neurosurgery
Main Authors Gebeyehu, Teleale F, Harrop, Catriona M, Barbieri, Lauren, Thalheimer, Sara, Harrop, James
Format Journal Article
LanguageEnglish
Published United States 17.05.2024
Subjects
Transitional Care
Phone Call
Follow Up
Unplanned Readmission
Communication
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Summary:Unplanned 30-day readmissions after surgery are a source of patient dissatisfaction, monitored by the Centers for Medicare and Medicaid Services, have financial penalties for hospitals and are publicly reported. Neurosurgical operations unfortunately have a higher 30-day unplanned readmission rate after the index discharge than other specialties. After a simple initiative for a 48-72-hour post discharge phone call, there was an observed significant drop-in readmission rate from 17% to 8% in 7 months at Thomas Jefferson University. To better understand the role of post operation phone calls for this reduction a retrospective evaluation over a longer period was performed. Assessment of quality improvement initiative using patient records between August 2018 and May 2023. The primary observed subject is the 30-day unplanned readmission rate and secondarily a change in physician communication score. 30-day unplanned readmission rate and physician communication scores before and after the phone call initiative were compared besides checking for difference, variance and correlation. 874 readmissions, average of 28 (95% CI 25.3 - 29.3) per month, 12.9% (95% CI 11.9 - 13.9) before phone call. 673 readmissions, average of 26 (95% CI 23 - 28.8) per month, 12.9% (95% CI 11.6 - 14.1) afterwards. Neither significant difference nor variance of scores or rates, nor correlation of rate with communication score was noted before and after the initiative. Phone calls and peri-discharge efficient communication is needed after neurological surgeries. This approach decreased unplanned readmissions in certain instances while not having a significant impact on neurosurgical patients.
ISSN:1878-8769