Date of Completion

12-12-2016

Embargo Period

12-12-2016

Keywords

patient satisfaction, cardiac arrhythmia ablation, patient education, enhanced patient education

Major Advisor

Dr Millicent Malcolm

Associate Advisor

Dr Juliette Shellman

Associate Advisor

Dr Suzanne Rose

Field of Study

Nursing

Degree

Doctor of Nursing Practice

Open Access

Open Access

Abstract

Patient satisfaction and 30-day hospital readmission rates are metrics used to assess quality of patient care. Dissatisfied patients pose a high risk of readmission (Boulding, Glickman, Manary, Schulman, Staelin, 2011) and during the vulnerable discharge period, 1 in 7 patients may experience an unavoidable readmission within 30-days post-procedure (Jencks, Williams, &Coleman,2009). Successful patient education programs have been linked to improved patient satisfaction and subsequently reduced unnecessary readmissions (Murdock& Griffin, 2013; Hansen et al., 2011). In an effort to increase satisfaction and reduce readmissions much of the healthcare community’s attention has turned to interventions that have these primary aims. Increased patient satisfaction and 30-day hospital readmission reduction post procedure have not been excessively studied in the cardiac arrhythmia ablation population, however these patients often present to their follow up appointments reporting that the procedure was not what was expected and report readmissions that could have been avoided (Ezzat, Chew, McCready, Lambiase, Chow, Lowe, Rowland, & Segal, 2013).

Utilizing a framework of the Health Belief Model (Janz & Becker, 1984), an enhanced post cardiac arrhythmia ablation education intervention based on the Project Red framework for re-engineering the discharge process, was delivered to patients in one practice who underwent cardiac arrhythmia ablation procedure with the aim of increasing patient awareness of their disease, clarifying post procedural expectations with the aim of increasing patient satisfaction, and reducing 30-day readmission rate in this population by providing the patient with education necessary to make an informed medical decision on when to seek care. Results of this study support the implementation of enhanced patient education intervention during the vulnerable 24-72 hour post discharge period by showing a higher total patient satisfaction score in the group receiving the intervention (M=633, SD=78) compared to (M=508, SD= 137) in the control group with a statistically significant difference between the means of the groups (p=.005). This study also showed a lower rate of 30-day readmissions in the intervention group (7.1%) compared to (53.3%) readmission rate of the control group with a statistically significant association (p=.014) and large magnitude of effect.

Results of this pilot study may be used for development and implementation of enhanced patient education programs aimed at increasing patient satisfaction and reducing 30-day readmission rates.

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