Date of Award
Open Access Thesis
Doctor of Nursing Practice (DNP)
Yale University School of Nursing
The prevalence of 30-day readmission after bariatric surgery is 0.6% to 11.3%, with a single hospital readmission nearly tripling the average 180-day cost of the surgery. Given that nearly 50% of early readmissions are preventable, close postoperative follow-up may allow for early identification of high-risk patients and preventative interventions.
This 7-month quality improvement project augmented clinical follow up post-bariatric surgery by incorporating a 7-10 day post-discharge call by an RD following a routine 1-3 day post-discharge call by an APP. Impact on readmission rate was examined. 166 participants included men and women ≥18 years of age, status post primary bariatric surgery only.
The proportion of patients experiencing a post-surgery hospital readmission or ED visit was evaluated across the sample, and stratified by procedure type and number of calls answered. Post-project readmission and ED visits were compared to those from the NYP Semi-Annual Report (SAR) using 2-sample tests of proportions. A clear downward trend was noted in the overall readmission rate for project participants (6.5% (SAR) vs. 4.8% (Project)). Readmission rate was related to procedure type: 9.2% (SAR) vs. 7.1% (Project) for post Roux-en-Y gastric bypass, and 5.4% (SAR) vs. 4% (Project), for sleeve gastrectomy. Patients who only connected on the 7-10 day post-discharge call had 0 readmission and post-operation ED visits.
Findings here are promising. Additional projects should be conducted on a larger scale and include factors that may place patients in a ‘higher risk’ category for readmission e.g., obstructive sleep apnea, diabetes, depression/anxiety, and history of DVT/PE.
Keywords: bariatric surgery, readmission, hospital readmission, sleeve gastrectomy, Roux-en-Y gastric bypass, readmission rates, readmissions, abdominal pain, nausea, vomiting, dehydration, complications
Sharma, Payal, "Reducing Early Hospital Readmission Rates After Bariatric Surgery" (2021). Yale School of Nursing Digital Theses. 1126.
This Article is Open Access