Date of Award

Spring 4-12-2023

Embargo Period

4-13-2023

Document Type

Dissertation

Degree Name

Doctor of Health Administration

Department

Health Administration

College

College of Health Professions

First Advisor

Annie Simpson

Second Advisor

Mary Dooley

Third Advisor

Ayad Hamdan

Abstract

Hospitals across the nation are facing extreme challenges with overcrowding. Unplanned readmissions and emergency department use are two significant contributors to this urgent issue. Historically, oncology patients are high utilizers of emergency department services, and have elevated numbers of unplanned readmissions. This is especially true of gastrointestinal medical oncology patients. In an effort to move the needle in the right direction, an operational quality improvement initiative to decrease emergency department utilization and unplanned readmissions was conducted. This pilot project took place over a three-month period, and consisted of protecting time for advanced practice providers (APPs) and updating inefficient workflows. The primary goal was to reduce the number of days between discharge from the inpatient setting, and days to first follow up appointment in the outpatient setting. A secondary goal was to reduce readmissions and emergency department (ED) utilization. Results showed that to improve transitions of care, implementation of a Donabedian modeled APP structural change, in combination with optimizing workflow, can reduce the length of time between 4 discharge from the inpatient (IP) setting to first follow up appointment. This change in return shows a correlation with a reduction in readmission rates and ED department utilization.

Rights

Copyright is held by the author. All rights reserved.

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