Reducing Early Readmissions after Ventral Hernia Repair with the Americas Hernia Society Quality Collaborative
| Autor: | Jonathan P. Yunis, Alfredo M. Carbonell, David L. Webb, Michael J. Rosen, Sharon Phillips, Randy J. Janczyk, DeAngelo A. Harris, William W. Hope, Nathaniel Stoikes, Benjamin K. Poulose, Guy R. Voeller, Jeremy A. Warren |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management MEDLINE Psychological intervention 030230 surgery Logistic regression Patient Readmission 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Surveys and Questionnaires Medicine Humans Hernia Registries Herniorrhaphy Aged business.industry Ventral hernia repair Odds ratio Middle Aged medicine.disease Quality Improvement Hernia Ventral United States 030220 oncology & carcinogenesis Emergency medicine Resource use Surgery Female business |
| Zdroj: | Journal of the American College of Surgeons. 226(5) |
| ISSN: | 1879-1190 |
| Popis: | Early readmission after ventral hernia repair (VHR) can hinder patient recovery and increase resource use. The objective of this study was to evaluate the effectiveness of the Americas Hernia Society Quality Collaborative Early Readmission Reduction Initiative in reducing early readmissions after VHR.Risk factors for early readmission and best practices of surgeons with the lowest readmission rates after VHR were determined through collaborative learning. Two interventions for reducing early readmissions were developed: a structured questionnaire administered to patients within 1 week after discharge from the hospital or an early clinic visit after discharge and before a regularly scheduled postoperative visit. Multivariable logistic regression was used to evaluate the impact of these interventions on early readmission.Use of the questionnaire and early clinic visit was tracked in 3,007 patients. Of these, 343 received the questionnaire (2.6% readmission rate), 761 had an early clinic visit after discharge (3.0% readmission rate), 138 had both (4.3% readmission rate), and 1,765 patients received neither (5.9% readmission rate). After controlling for factors associated with early readmissions, administration of the questionnaire (odds ratio 0.42; 95% CI 0.21 to 0.84; p0.05) or having an early clinic visit (odds ratio 0.48; 95% CI 0.30 to 0.76; p 0.05) were both associated with reduced odds for readmission.The Americas Hernia Society Quality Collaborative Early Readmission Reduction Initiative successfully reduced readmissions after VHR using a structured questionnaire or early clinic visit implemented after discharge and before routine 30-day postoperative follow-up. |
| Databáze: | OpenAIRE |
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