Improving the Transition of Care from the Hospital to Primary Care Providers  for Patients with Heart Failure

Blake, John

Publication:
Improving the Transition of Care from the Hospital to Primary Care Providers for Patients with Heart Failure

dc.contributor.advisor	Emma Dundon
dc.contributor.advisor	Emma Dundon
dc.contributor.advisor	Joan P. Roche
dc.contributor.advisor	Elaine L. Cohen
dc.contributor.advisor	Dundon, Emma
dc.contributor.advisor	Roche, P., Joan
dc.contributor.author	Blake, John
dc.contributor.department	University of Massachusetts Amherst
dc.contributor.department	Doctor of Nursing Practice
dc.contributor.department	Family Nurse Practioner
dc.date	2024-01-22T14:15:19.000
dc.date.accessioned	2024-04-26T19:36:41Z
dc.date.available	2024-04-26T19:36:41Z
dc.date.issued	2014-01-01
dc.date.submitted	May
dc.description.abstract	The goal of this quality improvement project was to enhance the transition of care from the hospital to primary care providers for patients with heart failure at one acute care hospital in Tampa, Florida. A literature review revealed that discharge summaries have a pivotal communication role in the transition of care. Consequently, the electronically recorded discharge summaries relating to a random sample of 60 patients discharged from this hospital were audited for a trial period of six months (three months before and three months after an intervention by the DNP candidate to encourage the attending physicians to improve the transition of care.) The following data were collected: (a) the extent to which the discharge summaries complied with the components mandated by the Joint Commission on the Accreditation of Healthcare Organizations (Standard IM.6.10, EP 7); (b) the extent to which six specified outcome indicators reflecting a high level of transition of care were implemented; and (c) the relative rates of hospital readmission within 30 days after discharge. The readmission rates were reduced by 10% after the intervention. The discharge summaries complied with all the standard components, but were deficient with respect to one indicator. A shortage of clinical pharmacists was associated with more than 10% of the patients not receiving medication reconciliation within 24-48 hours after discharge. Consequently, recommendations are made to expedite the process of medication reconciliation.
dc.identifier.doi	https://doi.org/10.7275/5587978
dc.identifier.uri	https://hdl.handle.net/20.500.14394/38077
dc.relation.url	https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1043&context=nursing_dnp_capstone&unstamped=1
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/3.0/
dc.source.status	published
dc.subject	transition of care
dc.subject	primary care provider
dc.subject	patients’ readmission
dc.subject	heart failure
dc.subject	post hospital follow up appointment
dc.subject	medication reconciliation
dc.subject	Nursing
dc.title	Improving the Transition of Care from the Hospital to Primary Care Providers for Patients with Heart Failure
dc.type	open
dc.type	article
digcom.contributor.author	isAuthorOfPublication\|email:jblake1103@msn.com\|institution:University of Massachusetts Amherst\|Blake, John
digcom.identifier	nursing_dnp_capstone/38
digcom.identifier.contextkey	5587978
digcom.identifier.submissionpath	nursing_dnp_capstone/38
dspace.entity.type	Publication