Leena Joseph

Implementation of Post-discharge Phone-call to Reduce 30-day Readmission after Cardiac surgery

Abstract Background: The cardiac surgery patient population requires multidisciplinary interventions to decrease their mortality and morbidity. Readmissions within 30-days after discharge from cardiac surgery that include coronary artery bypass grafting surgery (CABG), single or multiple valve surgery, or concomitant CABG and valve surgeries are frequent and add to the costs of cardiac surgery hospitalization. 

Methods: A quality improvement project focused on implementing a 48 -hour phone call by the Advance Practice Provider (APP) was completed to prevent unplanned readmission after cardiac surgery. Thirty-two patients were included in a convenience sample. A Chi-Square test was used to calculate the rate of readmission during the pre-and post-implementation period. 

Results: The rate of readmission during the pre-implementation period was 7% in 2019, 20% in 2020, 4% in 2021. The rate of readmission during the post implementation period was 16% in 2022. The reasons the patients were readmitted included chest pain, shortness of breath, dizziness, wound issues, and arrhythmia. No patients who were included in the project required APP intervention within 48-hours of discharge from cardiac surgery hospitalization. 

Conclusion: Complications after cardiac surgery exist despite prevention efforts. The post-discharge phone call was an add-on resource to improve the quality of care after cardiac surgery. It helped to facilitate the transition to home in post-discharge cardiac surgery patients. The post-discharge phone call by APP should be considered in all areas of medical and surgical practice to reinforce the discharge instructions and enhance transition of care from the inpatient to outpatient setting.

Keywords: Cardiac surgery, Readmission, Advance Practice Provider, Post-discharge phone call. 

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