Abstract T P250: The Impact of a Stroke Navigator in Decreasing Readmission Rates
Background and Purpose: Stroke continues to be the third leading cause of death in the United States and the leading cause of adult disability. A recent study published in Stroke looked at preventable readmission rates among Medicare beneficiaries with ischemic stroke. The study concluded that there is merit in looking at older age individuals, previous MI, CHF and diabetes as all of these are strong predictors of preventable readmissions. Stroke survivors often lack stroke specific education and continuity of care post discharge, resulting in unnecessary readmission to the hospital. Furthermore, stroke survivors often express the need for more information about stroke and risk factor management. The stroke navigator role is a transitional care role that was implemented to build relationships with patients while in the hospital, by providing stroke specific education, and continuing the relationship post discharge and during follow up care in a secondary stroke prevention clinic. The purpose of this study was to determine the efficacy of the navigator role in decreasing 30 day all cause readmission rates.
Methods: A retrospective review of the arithmetic observed vs. expected (O/E) all cause readmission rates for all ischemic strokes was analyzed 5 months prior and 5 months following implementation of the navigator role.
Results: Significant improvements in 30 day all cause readmission rates were found during the 5 months following implementation of the navigator role. The average O/E rate for the 5 months prior to implementation of the navigator role was 1.36 (14.05% observed readmission rate). The average O/E after navigator implementation dropped to 0.68 (6% observed readmission rate).
Conclusions: Implementation of the stroke navigator role showed improvement in 30 day all cause readmission rates. The decline in readmissions may be due to increased stroke education, understanding of risk factor management, which may enhance compliance to treatment, and close follow up by the stroke navigator, which may identify and prevent complications requiring readmission.
Author Disclosures: A. Eudy: None. J. Mesler: None. A. Vasudevan: None. C. Sombutmai: None. A. Reid: None. L. Leahy: None.
- © 2014 by American Heart Association, Inc.