Date of Award

January 2022

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Mary Ann Camilleri

Abstract

The social and economic burden associated with sepsis readmission remains a global healthcare issue. Sepsis survivors are at higher risk for physical debilitation, readmission, and death, yet despite advanced sepsis prevention and interventions, post-sepsis care and sepsis readmission reduction efforts, remain scant. Sepsis readmission costs ($500M /year) are more than the annual cost of acute myocardial infarction ($142M /year) and heart failure ($229M/year) combined. The overall goal of this DNP project was to reduce sepsis readmissions for patients identified as high risk for readmission using a standardized, safe discharge program (SDP) and implement it using a dynamic interdisciplinary collaborative approach. Given the lack of historical baseline data, the program success was based on the SDP’s utilization rate. In the 13-week project implementation, a total of 21 patients were enrolled in the SDP with an average utilization rate of 16%. Additionally, the pilot concluded that at least 92% of the providers indicated that the SDP effectively targets the patients at risk for readmission, the SDP criteria for patient enrollment are clear, and employees received adequate education on the SDP components. Despite the significant limitations of COVID-19 and workforce crisis on the program outcomes, the SDP carefully highlighted the value of establishing a baseline data and engaging the organization to include sepsis readmission rate as part of the quality dashboard. Hence, providing visibility to the 67 total admissions in the pilot unit with DRG 871 and 872 in 13 weeks, with a 12% average readmission rate, is a major success of the program. The SDP also emphasized the importance of accountability and effective collaboration of the interdisciplinary team towards effective sepsis readmission reduction efforts. Furthermore, the SDP results can serve as a solid business case to mobilize the integration of SDP in the EPIC electronic medical record for efficiency and sustainability across the enterprise.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 07/14/2023

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