Abstract 220: Understanding Nonattendance in Cardiac Transitional Care

Abstract

Background: Bridging the Discharge Gap Effectively (BRIDGE) is a nurse practitioner based transitional care clinic shown to reduce readmissions in acute coronary syndrome patients. Unfortunately, more than 20% of patients referred do not attend. This study aims to determine reasons for nonattendance. Methods: Patients who did not attend their BRIDGE appointments between February and June 2014 were contacted by phone and surveyed about their reasons for nonattendance. Patient records were abstracted for discharge (D/C) and BRIDGE appointment details. Results: Of 171 patients referred, 60 (35.1%) did not attend their BRIDGE appointment; 45 (75.0%) participated in the study. Reasons for nonattendance were grouped into five categories (Table 1). The majority of patients reported their health status (n=15) as a reason for nonattendance or simply made a choice to not attend (n=16). Many patients (n=30, 66.7%) did not recall receiving information about BRIDGE at D/C. However, of those who did (n=10) nearly all (90.0%) understood the rationale for the appointment (Table 2). A high percentage of these patients were readmitted within 30 days (n=11, 24.4%) and patients who reported being too ill to travel were readmitted more frequently (4 of 7, 57.1%). These rates are in stark contrast to the 8.3% 30-day readmission rate for attenders. Conclusions: Patients had a variety of reasons for nonattendance, illustrating multiple opportunities to impact attendance rates. Focus should be placed on identifying and addressing patients who are too ill to travel as they represent a population at high risk for complications post-discharge. Further research, in a larger sample, is warranted to better understand these patients and their transitional needs.