Reducing Early Hospital Readmission Rates After Bariatric Surgery

<p>The prevalence of 30-day readmission after bariatric surgery is 0.6% to 11.3%, with a single hospital readmission nearly tripling the average 180-day cost of the surgery. Given that nearly 50% of early readmissions are preventable, close postoperative follow-up may allow for early identification of high-risk patients and preventative interventions.</p> <p>This 7-month quality improvement project augmented clinical follow up post-bariatric surgery by incorporating a 7-10 day post-discharge call by an RD following a routine 1-3 day post-discharge call by an APP. Impact on readmission rate was examined. 166 participants included men and women ≥18 years of age, status post primary bariatric surgery only.</p> <p>The proportion of patients experiencing a post-surgery hospital readmission or ED visit was evaluated across the sample, and stratified by procedure type and number of calls answered. Post-project readmission and ED visits were compared to those from the NYP Semi-Annual Report (SAR) using 2-sample tests of proportions. A clear downward trend was noted in the overall readmission rate for project participants (6.5% (SAR) vs. 4.8% (Project)). Readmission rate was related to procedure type: 9.2% (SAR) vs. 7.1% (Project) for post Roux-en-Y gastric bypass, and 5.4% (SAR) vs. 4% (Project), for sleeve gastrectomy. Patients who only connected on the 7-10 day post-discharge call had 0 readmission and post-operation ED visits.</p> <p>Findings here are promising. Additional projects should be conducted on a larger scale and include factors that may place patients in a ‘higher risk’ category for readmission e.g., obstructive sleep apnea, diabetes, depression/anxiety, and history of DVT/PE.</p> <p>Keywords: bariatric surgery, readmission, hospital readmission, sleeve gastrectomy, Roux-en-Y gastric bypass, readmission rates, readmissions, abdominal pain, nausea, vomiting, dehydration, complications</p>

Name thesis:degree_name

Doctor of Nursing Practice (DNP)

Level thesis:degree_level

Open Access Thesis

Discipline thesis:degree_discipline

Yale University School of Nursing

Year

2021

Author dc:creator

• Sharma, Payal

Contributors dc:contributor

• Joan Kearney

• bariatric surgery
• complications
• hospital readmission
• Roux-en-Y gastric bypass
• sleeve gastrectomy

Repository record dc:identifier

https://elischolar.library.yale.edu/ysndt/1126

OAI identifier oai:identifier

oai:elischolar.library.yale.edu:ysndt-1125