ArticleJournal of the American College of Surgeons2017
Improving Patient-Centered Transitional Care after Complex Abdominal Surgery.
Article in Journal of the American College of Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- The effect of family-centered care on unplanned emergency room visits, hospital readmissions and intensive care admissions after surgery: a root cause analysis from a prospective multicenter study in the Netherlands.Patient safety in surgery · 2024Article
- A review on wound management strategies in enhanced recovery after craniotomy: An in-depth analysis of their influence on patient recovery and surgical outcomes.International wound journal · 2024Review
- Article
- Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review.JMIR aging · 2022Review
- Protocol for the MobiMD trial: A randomized controlled trial to evaluate the effect of a self-monitoring mobile app on hospital readmissions for complex surgical patients.Contemporary clinical trials · 2022Article
- Urgent need to take action on reducing postoperative respiratory complications.The Lancet regional health. Western Pacific · 2021Article
- A telephone-based surgical transitional care program with improved patient satisfaction scores and fiscal neutrality.Surgery · 2021Article
- Early vs Late Readmissions in Pancreaticoduodenectomy Patients: Recognizing Comprehensive Episodic Cost to Help Guide Bundled Payment Plans and Hospital Resource Allocation.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Extending Enhanced Recovery after Surgery Protocols to the Post-Discharge Setting: A Phone Call Intervention to Support Patients after Expedited Discharge after Pancreaticoduodenectomy.The American surgeon · 2020Article
- Discordance in Information Exchange Between Providers During Care Transitions for Surgical Patients.The Journal of surgical research · 2019Article
- Coordinated-Transitional Care for Veterans with Heart Failure and Chronic Lung Disease.Journal of the American Geriatrics Society · 2019Article
- Adaptation and Implementation of a Transitional Care Protocol for Patients Undergoing Complex Abdominal Surgery.Joint Commission journal on quality and patient safety · 2018Article
- Implementation of a Workflow Initiative for Integrating Transitional Care Management Codes in a Geriatric Primary Care Practice.Journal of nursing care qualityArticle
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Authors and funding
11 authors.
Funding
Abstract
backgroundPoor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY
designThe intervention includes in-person enrollment of patients. Follow-up protocolized phone calls by specially trained surgical C-TraC nurses addressed medication management, clinic appointments, operation-specific concerns, and identification of red-flag symptoms. Enrollment criteria included pancreatectomy, gastrectomy, operative small bowel obstruction or perforation, ostomy, discharge with a drain, in-hospital complication, and clinician discretion. Engaged patients participated in the first phone call, which was within 48 to 72 hours of discharge and continued every 3 to 4 days. Patients completed the program once they and surgical C-TraC nurse agreed that no additional follow-up was needed or the patient was readmitted.
resultsTwo hundred and twelve patients were enrolled, October 2015 through April 2016, with a mean age of 56 years (range 19 to 89 years); 33% of patients were 65 years or older. Surgery sites included colon (46%), small bowel (16%), pancreas (12%), multivisceral (9%), liver (4.5%), retroperitoneum/soft tissue (4.5%), gastric (4%), biliary (2%), and appendix (1.5%). Refusal rate was 1% and engagement was 95%. At initial call, 47% of patients had at least 1 medication discrepancy (range 0 to 6). Mean number of calls from provider to patient was 3.2 (range 0 to 20, median 3).
conclusionsA phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement. Medication management is a prominent issue. Future studies are needed to assess the impact of surgical C-TraC on post-discharge healthcare use.
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