IMPACT OF ENHANCED DISCHARGE EDUCATION ABOUT SEPSIS ON 30-DAY SEPSIS READMISSIONS: QUALITY IMPROVEMENT PILOT PROGRAM AT A LARGE TERTIARY CARE CENTER

ABSTRACT

SESSION TITLE Sepsis Beyond 30cc/kg and Antibiotics SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/19/2022 1115 am - 1215 pm PURPOSE: Sepsis is the leading cause of hospitalization and mortality in the United States. In addition, sepsis is, by volume, the leading cause of 30 day readmissions across all payer mix in the United States. The risk factors for 30 day readmissions are multifactorial and often portends poor outcomes and increase hospitalization costs. We trialed a pilot program of enhanced sepsis discharge education which consisted of direct patient education prior to discharge, providing a Sepsis Education brochure with tips on self management at home as well as a QR code to direct patients to institutional website in case they needed further assistance, and finally a disposable thermometer to maintain an accurate temperature log to aid in monitoring for signs and symptoms of sepsis. Our primary goal was educate patients about their diagnosis and reduce sepsis readmissions in all non-medicare patients being discharged home. METHODS: The pilot was implemented at on one med/surg unit in our 550-bed tertiary, academic medical center starting in March 2021 and progressively expanded hospital wide over the next six months. The sepsis administrative coordinator screens new in-patient admissions for sepsis (non-Medicare) patients daily and informs medical/surgical unit coordinators of potential candidates. Med/surg coordinators will confirm if patients meet criteria for follow-up (non-Medicare, being discharged to home), provide discharge education and enter the patient in a log for continued surveillance. Subsequently, the administrative coordinator then follows up with a phone call 7-10 days after discharge during which, they assess the patient for worrisome symptoms, confirms follow up appointments, medication compliance and review of temperature log. If the patient needs clinical assistance, they will refer to the patient to the hospital sepsis clinical coordinator or patient’s outpatient physicians. RESULTS: We compared sepsis discharges and 30day readmissions (all excluding COVID-19 cases) from March 1, 2019 – Dec 31, 2019 to March 1, 2021 – Dec 31, 2021. Readmissions amongst Medicare patients discharged home was 15.9 % (110 / 962) in 2019 vs 11.9% (83 / 696) in 2021. For non-medicare patients, the rate was 13.2% (41/311) in 2019 vs 13.1% (51/390) in 2021. In our pilot program, the readmission rate in medicare patients was 17.2% (28/163) versus 5.6% (5/90) in non-medicare patients. CONCLUSIONS: This program captures a patient population which may have been lost to follow-up. Implementation of the enhanced Sepsis Discharge Education led to at least a 30 patient reduction in readmissions yielding an approximate cost savings of $594,000. CLINICAL IMPLICATIONS Providing educational support, instructions, and follow up calls upon discharge improves medication adherence, compliance, and maintains patient follow up thus reducing readmissions and improving hospital resource utilization and overall cost. DISCLOSURES No relevant relationships by Laura Freire No relevant relationships by Nirav Mistry No relevant relationships by Caitlin Tauro