Ileostomy Pathway Virtually Eliminates Readmissions for Dehydration in New Ostomates

Abstract

A simple, educational program for new ileostomy patients that includes preoperative teaching, standardized teaching materials, in-hospital engagement, observed management, and postdischarge tracking of intake and output is very effective in decreasing hospital readmission. The average length of stay remained stable, despite the addition of this teaching program to our perioperative/inpatient care.

General and Vascular Surgery Readmissions: A Systematic Review

“…(For a review of models predicting readmission, see Kansagara, et al(8)) There was one institutional study by Nagle and colleagues that prospectively instituted an “ileostomy pathway” in order to reduce readmissions and facilitate patient education and well-being. (47) Their group was able to demonstrate a significant decrease in dehydration-related readmissions and a decreasing trend in overall readmissions after implementation of the pathway.…”

“…Readmission rates were reported at 28-days,(39) 30-days,(11,13–24,27–38,40,42–47) 6-weeks,(26) 60-days,(30,48) 90-days,(12,18,25,30,34) 6-months,(10) 1-year,(18,33) 2-years(26) and >2-years. (26) In one article interval to readmission was not defined.…”

“…In two studies, 30-day readmission rates were quite high; specifically in patients that underwent ileal-anal pouch anastomosis (30.3%)(44) or creation of an ileostomy (32.5%). (47) With these two studies removed, the median readmission rate for colorectal was 12.0%.…”

Clinical Practice Guidelines for Ostomy Surgery

“…in published reports, these programs have been associated with low rates of readmission for dehydration, suggesting the promise of such programs. [77][78][79] …”

Producing the Triple Aim Through a TeleWound Solution

“…Other similar education focused care transitions models (even exclusive of Telehealth functionality) showed significant reduction in readmissions for ileostomy patient dischargesreadmission rate for dehydration was 15.5% for patients without the post discharge follow-up and education, but dropped to 0% in the study group. 2 …”