Abstract

Rehospitalizations is a national problem and is not safe for the frail elderly who have ongoing management of multiple chronic conditions. To address rehospitalization rates that were above the state and national average, a quality improvement change in practice was implemented in a midsized home health agency. The objective of this study was to reduce rehospitalization rates by implementing a hospital readmission prevention toolkit that adhere to evidence-based practice strategies applicable to home health clients that have shown to reduce avoidable rehospitalizations. The hospital readmission prevention toolkit will improve client outcomes through education, implementation, and consistent use of a practice change of hospital readmission prevention best practice tools that include: a risk assessment for rehospitalizations, front-loading nurses' visits, client weekly phone monitoring, and timely documentation. The hospital readmission prevention toolkit was effective in decreasing the home health agency's rehospitalization rates over a 60 days period by 40%. The study concluded that when properly educated on the home health agency gap in practice, provided with supportive tools, and properly educated on the implementation of evidence-based practice interventions; rehospitalization rates decreased and client communication and collaboration increased improving client outcomes.

Author Details

Annette Wingard, DNP, RN

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Decreasing Rehospitalizations, Home Healthcare, Best Practices in Home Health, Unnecessary Hospitalizations, Preventing Readmissions in Home Healthcare

Advisor

Allison Terry

Second Advisor

Laurie Kohring

Third Advisor

Terri Jones

Fourth Advisor

Jayson Valerio

Degree

DNP

Degree Grantor

Capella University

Degree Year

2019

Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2020-02-11

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