| dc.description.abstract | Abstract Background: Blood cancers affect thousands of people each year. Allogeneic stem cell transplantation is a potential cure for those diagnosed with leukemia or lymphoma. As part of this complicated treatment, patients are hospitalized for at least 30 days after their transplant. During those 30 days, the patient is being cared for by an entire team of health care professionals 24 hours a day, 7 days a week. Discharging from the hospital after this time can be a significant transition for many, as they adjust to the new changes and expectations of their post-transplant life. Currently there is not a standardized process to facilitate this transition. Ample research exists regarding discharge follow- up telephone appointments’ impact on patient outcomes in an array of specialties. However, there is currently not a discharge follow-up telephone appointment for patients with allogenic transplants between discharge and outpatient clinic visit. Purpose: The purpose of this quality improvement project was to implement an Advanced Practice Registered Nurse (APRN) delivered post-discharge follow- up telephone appointment for allogeneic stem cell transplant patients. Methods: A post-discharge telephone-administered appointment was conducted with patients who have received an allogeneic stem cell transplant. The telephone script, developed and approved by the University of Kansas Health System (TUKHS) Cancer Center team, was used when making the calls. The project location was the outpatient Blood and Marrow Transplant clinic at TUKHS. Data were collected from chart audits for demographics, medical history, medications, and readmissions. The project outcomes were readmission rates and adherence to medication regimen. Results: At the completion of project, a total of 10 telephone calls were made. The results of these calls were then reviewed and compared to patients who did not receive a telephone call, using a retrospective chart review. The population of both the group who received the call and the retrospective chart review group were comparable, with the average age being 55.6 years and 52.8 years respectively. Both groups identified predominantly as Caucasian white (90% and 100%). The group receiving the phone call did not have any readmissions, whereas 20% of the retrospective chart review group was readmitted. Also, in the group that received the phone call, only 10% were found to have sub therapeutic tacrolimus drug levels needing intervention, whereas 20% of the group that did not receive the phone calls had documented sub therapeutic levels. Forty percent of both groups experienced procedural readmissions for issues such as fever, central line removal, and esophageal duodenoscopy (EGD)/ colonoscopy for graft versus host disease evaluation. Follow up phone calls give the provider an opportunity to not only monitor the patient more closely, but connect with them as well. By reaching out to patients after they have left the hospital the provider ensures the patient is safe and without complication, while also continuing to build a trusting relationship with each patient. Keywords: follow-up phone call, discharge phone call, transitional care, APRN, and allogeneic stem cell transplant | |
