Date of Conferral
Doctor of Nursing Practice (DNP)
Diane K. Whitehead
Transferring from an acute care setting to a sub-acute rehabilitation (SAR) setting can be challenging for both patients and providers because communication errors may occur. The purpose of this project was to evaluate the effectiveness of a 2017 quality improvement (QI) initiative that was implemented to reduce 30-day rehospitalization in a SAR setting serving older patients. The project involved an evaluation of the implementation of the Situation, Background, Assessment, and Recommendation (SBAR) tool for patient rounding to decrease the incidence of 30-day re-hospitalizations. Aristotle's linear model of communication, which emphasizes the impact of message delivery on audience response, provided the framework for this project. The evaluation project was conducted using the project organization's internal database to determine if the 2017 QI initiative reduced 30-day readmissions to the hospital. Data were evaluated 3 months before the implementation of the 2017 QI initiative and 3 months after the start of the project. Components reviewed included the length of stay, clinician authorizing the transfer, day of the week, time of transfer, reason, and outcome of the transfer. There was a significant decrease in return-to-hospital for Monday through Friday, but an increase was seen on the weekend (Saturday-Sunday), mainly in the morning and evening. Full-time staff who had participated in the education program worked Monday through Friday. Weekend staff were part-time staff who had not participated in the SBAR training. There was no consistency in the reason for transfer to hospital. The introduction of the SBAR education program had a positive effect on the quality of life of patients readmitting to the hospital.