Teamwork contributes to quality and may also reduce incivility and improve nurse retention. An evaluation of a TeamSTEPPS implementation in an intensive care unit included an assessment of teamwork, retention, and incivility. Teamwork improvement occurred from the initial assessment to 3 months later (U = 650, p = .001). Nurses planning to stay increased from 58% in 2016 to 89% in 2018. There was no change in incivility. The study provides strategies and lessons learned.
This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants and their family caregivers were highly satisfied with the program. The 30-day readmission rate for adult day program participants was significantly lower than that for nonparticipants. An expanded adult day program may represent a viable Transitional Care Model for selected patients and a feasible alternative to skilled nursing facility and home health care for PAC.
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