Location
Philadelphia, PA
Start Date
10-5-2021 12:00 AM
End Date
13-5-2021 12:00 AM
Description
Introduction: Acute cerebrovascular disease ranks among the top causes of 30-day readmissions. Studies have shown that enhancing and streamlining transitions of care (TOC) for patients can improve readmission rates for many conditions. Our research explores the impact of in-person and telemedicine TOC stroke clinic on readmission rates at an urban comprehensive stroke center. Methods: Participants were identified by ICD-10 diagnoses corresponding with stroke or transient ischemic attack at Thomas Jefferson University Hospital (TJUH). Starting in January of 2019, an in-person TOC clinic visit with a vascular neurologist or nurse practitioner was automatically scheduled within 1-3 weeks for patients discharged to home. When coronavirus precautions began, these visits transitioned to telemedicine. Follow-up telephone surveys assessing self-efficacy, confidence and perceived value of TOC clinic were administered. Readmission statistics were collected from the TJUH electronic health record. Preliminary data analysis was performed in SPSS. Results: 208 individuals (113 in-person, 95 telemedicine) seen in TOC clinic were included in preliminary analysis. The 30-day all-cause readmission rate was 5.8% (12 patients). Of these readmissions, 2 were seen in the clinic (2.1%), and 10 were evaluated via telemedicine (8.8%). Chi Square revealed a between group difference (X2 = 4.318, p = 0.038). Participants in both the in-person group (u = 8.421, SD = 1.835) and telemedicine group (u = 8.100, SD = 1.875) considered TOC a valuable experience. Analysis of perceived TOC value did not differ between groups (t = 0.654, p = 0.515). Discussion: Stroke readmissions represent a significant source of morbidity, mortality and healthcare spending in the United States. Overall, there were fewer readmissions among TJUH TOC clinic patients compared to institutional and national 30-day stroke readmission rates. Understanding the relative impact of an in-person and telemedicine TOC stroke clinic will provide valuable information as healthcare systems navigate the post-COVID era.
Embargo Period
6-7-2021
Reducing Readmission Rates By Improving Transitions Of Care For Stroke Patients In The Pre-Covid And Covid Eras
Philadelphia, PA
Introduction: Acute cerebrovascular disease ranks among the top causes of 30-day readmissions. Studies have shown that enhancing and streamlining transitions of care (TOC) for patients can improve readmission rates for many conditions. Our research explores the impact of in-person and telemedicine TOC stroke clinic on readmission rates at an urban comprehensive stroke center. Methods: Participants were identified by ICD-10 diagnoses corresponding with stroke or transient ischemic attack at Thomas Jefferson University Hospital (TJUH). Starting in January of 2019, an in-person TOC clinic visit with a vascular neurologist or nurse practitioner was automatically scheduled within 1-3 weeks for patients discharged to home. When coronavirus precautions began, these visits transitioned to telemedicine. Follow-up telephone surveys assessing self-efficacy, confidence and perceived value of TOC clinic were administered. Readmission statistics were collected from the TJUH electronic health record. Preliminary data analysis was performed in SPSS. Results: 208 individuals (113 in-person, 95 telemedicine) seen in TOC clinic were included in preliminary analysis. The 30-day all-cause readmission rate was 5.8% (12 patients). Of these readmissions, 2 were seen in the clinic (2.1%), and 10 were evaluated via telemedicine (8.8%). Chi Square revealed a between group difference (X2 = 4.318, p = 0.038). Participants in both the in-person group (u = 8.421, SD = 1.835) and telemedicine group (u = 8.100, SD = 1.875) considered TOC a valuable experience. Analysis of perceived TOC value did not differ between groups (t = 0.654, p = 0.515). Discussion: Stroke readmissions represent a significant source of morbidity, mortality and healthcare spending in the United States. Overall, there were fewer readmissions among TJUH TOC clinic patients compared to institutional and national 30-day stroke readmission rates. Understanding the relative impact of an in-person and telemedicine TOC stroke clinic will provide valuable information as healthcare systems navigate the post-COVID era.