Reducing Stroke Readmission Through the Implementation of Telehealth

Practice Problem: Readmission occurs frequently among patients with stroke and because of this, the Centers for Medicare and Medicaid Services (CMS) have imposed programs to reduce 30-day readmissions among hospitals. The health care system must respond with transition of care, especially during the period of recent stroke to improve patient outcomes. PICOT: The PICOT question that guided this project was among patients with a recent diagnosis of stroke (P), what is the effect of a telehealth appointment with a nurse practitioner (NP) for post discharge follow-up (I), compared to a standard face-to-face clinic appointment (C), on 30-day readmissions rates (O), within two months (T)? Evidence: Stroke is the fourth leading cause of death and has a readmission rate of 14%. Past studies have demonstrated the effectiveness of telehealth in treating patients outside of the hospital setting, which suggests the potential of telehealth on post-discharge follow-up care. Intervention: To assess the impact of telehealth on 30-day readmission rates, stroke patients received a telehealth follow-up phone visit by a NP within ten days of being discharged to home. Outcome: Data was collected from participant’s electronic health records (EHR) and discharge databases from October 13 to November 13, 2020. Among participants, the implementation of telehealth visits demonstrated a reduced readmission rate of 6.25% for stroke patients. Conclusion: Telehealth is an effective, sustainable, and widely implementable strategy to provide post-discharge care to patients. This study outlined a framework to further analyze the effectiveness of telehealth visits in reducing 30-day readmission rates among stroke patients.