000			03009nam a22003737a 4500
008			180619s20182018 xxu||||| |||| 00| 0 eng d
022			_a2397-5776
024			_a10.1136/tsaco-2017-000149 [doi]
024			_aPMC5887824 [pmc]
024			_atsaco-2017-000149 [pii]
040			_aOvid MEDLINE(R)
099			_a29766133
245			_aTrauma Transitional Care Coordination: protecting the most vulnerable trauma patients from hospital readmission.
251			_aTrauma Surgery & Acute Care Open. 3(1):e000149, 2018.
252			_aTrauma surg. acute care open. 3(1):e000149, 2018.
253			_aTrauma surgery & acute care open
260			_c2018
260			_fFY2018
266			_d2018-06-19
520			_aBackground: Unplanned hospital readmissions increase healthcare costs and patient morbidity. We hypothesized that a program designed to reduce trauma readmissions would be effective.
520			_aDiscussion: A nursing-led TTCC program successfully followed patients and was associated with a significant decrease in 30-day readmission rates for patients with high-risk trauma. Targeted outpatient support for these most vulnerable patients can lead to better utilization of outpatient resources, increased patient satisfaction, and more consistent attainment of preinjury level of functioning or better.
520			_aLevel of evidence: Level IV.
520			_aMethods: A Trauma Transitional Care Coordination (TTCC) program was created to support patients at high risk for readmission. TTCC interventions included call to patient (or caregiver) within 72hours of discharge to identify barriers to care, complete medication reconciliation, coordination of appointments, and individualized problem solving. Information on all 30-day readmissions was collected. 30-day readmission rates were compared with center-specific readmission rates and population-based, risk-adjusted rates of readmission using published benchmarks.
520			_aResults: 260 patients were enrolled in the TTCC program from January 2014 to September 2015. 30.8% (n=80) of enrollees were uninsured, 41.9% (n=109) reported current substance abuse, and 26.9% (n=70) had a current psychiatric diagnosis. 74.2% (n=193) attended outpatient trauma appointments within 14 days of discharge. 96.3% were successfully followed. Only 6.6% (n=16) of patients were readmitted in the first 30 days after discharge. This was significantly lower than both center-specific readmission rates before start of the program (6.6% vs. 11.3%, P=0.02) and recently published population-based trauma readmission rates (6.6% vs. 27%, P<0.001).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Washington Hospital Center
656			_aSurgery
657			_aJournal Article
700			_aHall, Erin C
790			_aHall EC, Scalea TM, Stein DM, Tyrrell R
856			_uhttps://dx.doi.org/10.1136/tsaco-2017-000149 _zhttps://dx.doi.org/10.1136/tsaco-2017-000149
942			_cART _dArticle
999			_c3417 _d3417