P2.06-041 TeleNursing: A Thoracic Surgery Nursing Initiative Aimed at Decreasing Hospital Readmissions and Increasing Patient Satisfaction: Topic: LAB, Other

Abstract

In the USA there is a national initiative in healthcare to decrease hospital readmissions, decrease the cost of care while patients are hospitalized and to increase patient. A recent study evaluating mortality rates in the lung cancer resection patients reported a 30-day readmission was associated with a 6-fold increase in the 90-day mortality of this patient population (14.4% vs 2.5%). This report not only forces thoracic surgery teams to extend their operative mortality focus and reporting beyond the traditional 30-day time period but it also emphasizes the critical value and positive impact continued post-operative care for the first three months after discharge can have on patient outcomes. The expert care delivered by thoracic surgery nurses plays a critical role in decreasing post-operative complications and ensuring patients are safely discharged from the hospital. The valuable impact thoracic surgery nurses have on preventing hospital readmissions and improving patient satisfaction is the intended focus of this clinical trial. The positive impact telehealth interventions have on multiple different disease processes supports investigation of this care modality for the thoracic surgery patient population. We have designed a clinical trial focused on implementing a TeleNursing program with the specific aims of preventing hospital readmissions and improving patient satisfaction. Our thoracic surgery practice currently has a “day-after-discharge” follow-up phone call program that is directed by the thoracic surgery nurses in the practice. Pertinent clinical details of each patient’s post-operative course are relayed to the thoracic surgery nurses. The nurses call patients 2-3 days after discharge and asked questions related to medications, pain management, sign or symptoms of infection, activity level and expectations, sleep, appetite and general understanding of all discharge instructions. This interaction is documented in the electronic medical record. This program has been expanded to compare the efficacy of the phone calls vs scheduled video-calls between nurses and patients. Patients are randomized to standard of care day after discharge phone calls vs the TeleNursing follow-up video-call; discharge day 2, 1-month, 2-month and 3-month. All patients complete a patient satisfaction questionnaire at predetermined time points. The primary objective is to decrease hospital readmission rates and the secondary objective is to improve patient satisfaction. Although the results of this clinical trial are pending, interim analysis indicates that patients are willing to participate in this program and are pleased with the nurse-patient interaction beyond their hospital stay. This clinical investigation is ongoing.