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Reducing non-surgical readmissions on a gynecologic oncology service.

Publication ,  Journal Article
Watson, CH; Monuszko, K; Freeman, S; Kurtovic, K; Davidson, BA; Havrilesky, LJ
Published in: Gynecol Oncol
April 2022

OBJECTIVE: To assess the effects of a quality improvement (QI) initiative designed to reduce non-surgical readmissions on a gynecologic oncology service. METHODS: A two-phase QI initiative was implemented on an inpatient gynecologic oncology service to reduce non-surgical 30-day readmissions. Phase 1, from July 2018 to June 2020, included trainee education, frequent physical therapy consultation, pharmacy discharge medication review, 72-h post-discharge telephone call, and standardized 10-day clinic follow-up after discharge. Phase 2, from July 2020 to December 2020, incorporated a nurse practitioner to perform discharge navigation and arrange outpatient follow-up. The incidence of non-surgical readmissions during these phases was compared to that of a baseline period (July 2017-June 2018). We also assessed readmissions to identify common indications and evaluate potential demographic and clinical risk factors. RESULTS: Of 390 total non-surgical gynecologic oncology admissions, 100 were readmitted within 30 days (25.6%). Gastrointestinal tract (GI) obstruction, malignancy-associated pain and infection were the most common symptomatic diagnoses at the index admission, and 30% of readmitted patients had an identical indication for readmission. Compared to the baseline period, we observed a reduction in non-surgical readmissions from 34.1% to 22.6% in Phase 1 and to 18.9% in Phase 2 (p < 0.03) based on internal review, and a reduction from 13.9% to 11.9% in Phase 1 and to 4.7% in Phase 2 (p = 0.04) based on healthcare performance tracking data. CONCLUSIONS: 30-day hospital readmission among non-surgical gynecologic oncology patients is common. Implementation of a multifaceted readmissions reduction QI initiative significantly improved readmission rates.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

April 2022

Volume

165

Issue

1

Start / End Page

4 / 10

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Patient Readmission
  • Patient Discharge
  • Oncology & Carcinogenesis
  • Humans
  • Genital Neoplasms, Female
  • Female
  • Aftercare
  • 3215 Reproductive medicine
 

Citation

APA
Chicago
ICMJE
MLA
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Watson, C. H., Monuszko, K., Freeman, S., Kurtovic, K., Davidson, B. A., & Havrilesky, L. J. (2022). Reducing non-surgical readmissions on a gynecologic oncology service. Gynecol Oncol, 165(1), 4–10. https://doi.org/10.1016/j.ygyno.2022.01.004
Watson, Catherine H., Karen Monuszko, Sarah Freeman, Kelli Kurtovic, Brittany A. Davidson, and Laura J. Havrilesky. “Reducing non-surgical readmissions on a gynecologic oncology service.Gynecol Oncol 165, no. 1 (April 2022): 4–10. https://doi.org/10.1016/j.ygyno.2022.01.004.
Watson CH, Monuszko K, Freeman S, Kurtovic K, Davidson BA, Havrilesky LJ. Reducing non-surgical readmissions on a gynecologic oncology service. Gynecol Oncol. 2022 Apr;165(1):4–10.
Watson, Catherine H., et al. “Reducing non-surgical readmissions on a gynecologic oncology service.Gynecol Oncol, vol. 165, no. 1, Apr. 2022, pp. 4–10. Pubmed, doi:10.1016/j.ygyno.2022.01.004.
Watson CH, Monuszko K, Freeman S, Kurtovic K, Davidson BA, Havrilesky LJ. Reducing non-surgical readmissions on a gynecologic oncology service. Gynecol Oncol. 2022 Apr;165(1):4–10.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

April 2022

Volume

165

Issue

1

Start / End Page

4 / 10

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Patient Readmission
  • Patient Discharge
  • Oncology & Carcinogenesis
  • Humans
  • Genital Neoplasms, Female
  • Female
  • Aftercare
  • 3215 Reproductive medicine