Location
Spectrum Theatre
Start Date
30-3-2019 9:00 AM
End Date
30-3-2019 10:15 AM
Session Chair
Dr. Gayle L. Casterline
Mentor
Dr. Tracy Arnold
Description
Acute pancreatitis results in approximately 300,000 hospital admissions in the United States each year, at a cost of approximately $2.2 billion. Necrotizing pancreatitis, the more severe form, is defined as necrosis of the pancreatic parenchyma with or without necrosis of the peripancreatic tissues. There has been an increase in readmission rates for this patient population, especially with necrotizing pancreatitis. It occurs as a complication in 20%–30% of patients with acute pancreatitis and historically has been associated with high rates of morbidity (34%–95%) and mortality. Mortality and readmission within the first two weeks after surgery and discharge to home with Home Health Care (HHC) is mostly due to infection, systemic inflammatory response syndrome, which is an exaggerated inflammatory response associated with systemic organ dysfunction, immunosuppression, and organ failure. It was discovered that discharge home with HHC has recently been implicated as a risk factor for readmission after major abdominal surgery due to varying experience and lack of expertise in caring for this patient population. Open abdominal surgical necrosectomy at Atrium Health in Charlotte North Carolina hepatopancreaticobiliary (HPB) unit has been considered one of the definitive treatments for symptomatic pancreatic necrosis, including infected necrosis. As one of the largest HPB programs in the country, the latest surgical techniques and technologies to help get the best possible results are used. This is because these are often highly complicated cases affecting multiple organs. The team work together with experts in other medical specialties, including oncologists, gastroenterologists, therapeutic endoscopists, interventional radiologists and hepatologists in providing patients with specialized and complete care. Registered Nurses (RN), Social Workers, Case Managers, and Health Care Providers in HPB unit at Atrium Health received education on long term acute care hospitals (LTACHs) criteria for admission and Medicare guidelines that allow patients to be discharged to an LTACH facility. The purpose of this project is to improve patient outcomes and reduce the cost of care by transitioning abdominal surgical patients with high acuity to specialized long-term acute care hospitals (LTACHs) rather than home with home health care. The implementation of an evidence-based practice (EBP) on the roleof Long-Term Acute Care Hospitals (LTACHs) will help manage length of stay, manage cost, reduce readmission rates after a recent discharge from the hospital, and improve post-discharge outcomes.
Keywords:necrotizing pancreatitis, readmission, long term acute care hospital
Included in
Session I Nursing Presentation 2: The Role of Long-term Acute Care Hospitals (LTACHs) in Improving Outcomes for Patients with Necrotizing Pancreatitis
Spectrum Theatre
Acute pancreatitis results in approximately 300,000 hospital admissions in the United States each year, at a cost of approximately $2.2 billion. Necrotizing pancreatitis, the more severe form, is defined as necrosis of the pancreatic parenchyma with or without necrosis of the peripancreatic tissues. There has been an increase in readmission rates for this patient population, especially with necrotizing pancreatitis. It occurs as a complication in 20%–30% of patients with acute pancreatitis and historically has been associated with high rates of morbidity (34%–95%) and mortality. Mortality and readmission within the first two weeks after surgery and discharge to home with Home Health Care (HHC) is mostly due to infection, systemic inflammatory response syndrome, which is an exaggerated inflammatory response associated with systemic organ dysfunction, immunosuppression, and organ failure. It was discovered that discharge home with HHC has recently been implicated as a risk factor for readmission after major abdominal surgery due to varying experience and lack of expertise in caring for this patient population. Open abdominal surgical necrosectomy at Atrium Health in Charlotte North Carolina hepatopancreaticobiliary (HPB) unit has been considered one of the definitive treatments for symptomatic pancreatic necrosis, including infected necrosis. As one of the largest HPB programs in the country, the latest surgical techniques and technologies to help get the best possible results are used. This is because these are often highly complicated cases affecting multiple organs. The team work together with experts in other medical specialties, including oncologists, gastroenterologists, therapeutic endoscopists, interventional radiologists and hepatologists in providing patients with specialized and complete care. Registered Nurses (RN), Social Workers, Case Managers, and Health Care Providers in HPB unit at Atrium Health received education on long term acute care hospitals (LTACHs) criteria for admission and Medicare guidelines that allow patients to be discharged to an LTACH facility. The purpose of this project is to improve patient outcomes and reduce the cost of care by transitioning abdominal surgical patients with high acuity to specialized long-term acute care hospitals (LTACHs) rather than home with home health care. The implementation of an evidence-based practice (EBP) on the roleof Long-Term Acute Care Hospitals (LTACHs) will help manage length of stay, manage cost, reduce readmission rates after a recent discharge from the hospital, and improve post-discharge outcomes.
Keywords:necrotizing pancreatitis, readmission, long term acute care hospital