S184 S290
Poster 161:
Increasing Compliance with Using the Standardized
Patient Admission Report Through Email
Communication
Ellia Ciammaichella (University of Texas Health Science Center,
Houston, TX, USA), Tomasz K. Podobinski, DO, Kelly Cameron, MD,
Abana F. Azariah, MD, Tony Nguyen, MD, Elham Cohen, MD,
Christopher M. Falco, MD
Disclosures:
Ellia Ciammaichella: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To optimize transition of care with admissions at one
acute inpatient rehabilitation facility by increasing overall nursing
compliance with the “Patient Admission Report” (Report) by 25%.
Design:
To determine whether compliance improved after the inter-
vention, pre- and post-intervention compliance were assessed as fol-
lows: Pre-intervention compliance was determined by collecting data
over a random but consecutive two-week period in Spring 2016. Ten
days after the intervention was provided, post-intervention data was
collected for two weeks. During each of these two weeks, the Inves-
tigator reviewed all new admissions for the presence or absence of the
completed Report.
Setting:
Acute inpatient rehabilitation facility.
Participants:
Long Le, MD, Kelly Cameron, MD, Elham Cohen, MD,
Abana Azaria, MDh, Tomasz Podobinski, DO, Ellia Ciammaichella, DO,
Tony Nguyen, MD, Siddarth Thakur, MD, Christopher Falco, MD
Interventions:
An email was sent out to all nursing staff with detailed
explanation to complete and how to complete the Report. In addition,
the nursing floor managers were emailed with a reminder. A copy of
the Report was also included in the email.
Main Outcome Measures:
The main outcome measure was compli-
ance, which was measured by inspecting the physical chart for the
completed Report. The presence of a completed Report in the chart
was considered compliant and the absence of a completed Report was
considered noncompliant.
Results:
Overall compliance pre-intervention was 45% and post-
intervention was 56%. With p-.001 no significant difference was found.
Conclusions:
The study showed compliance improved with the inter-
vention but this finding was not statistically significant. This may be
due to: the type of intervention (one email), lack of impact of the
email, the possibility that it was not read, lack of incentive to
encourage compliance, or loss or misplacement of any completed
Report.
Level of Evidence:
Level II
Poster 162:
A Practice Improvement Project to Decrease Falls in
Patients Discharged from Acute Rehabilitation
Jamal Khan, DO (SUNY At Stony Brook, Valley Stream, NY, United
States), Karen I-Kemper, OT, Michael Scicchitano, PT, Jun Zhang, MD,
Jennifer Semel, MD
Disclosures:
Jamal Khan: I Have No Relevant Financial Relationships
To Disclose
Objective:
Practice improvement project to decrease falls after
discharge from acute rehabilitation.
Design:
Patients discharged from acute rehabilitation were surveyed
via MedTel 3 months after discharge beginning in January 2015. They
were asked whether they had sustained a fall since being discharged. A
fall education class was implemented in October 2015 and data were
collected through July 2016.
Setting:
Community rehabilitation hospital.
Participants:
All patients discharged from acute rehabilitation,
including patients who went home or to another facility. The survey
had an 80% response rate.
Interventions:
A comprehensive fall prevention and home safety ed-
ucation class was implemented in October 2015. It was offered to all
inpatient rehabilitation patients and their family members. The class
addressed topics such as client factors, environmental factors and
additional preventive strategies. Patients were educated on their risk
of falling based on factors such as medication side effects or visual
problems, and were given specific fall prevention interventions to
complete in their homes. Patients were also given community resource
information to help them and their family members prevent falls after
discharge.
Main Outcome Measures:
Telephone survey conducted 3-months post
discharge by MedTel.
Results:
For 2015, 131 out of 572 total patients (22.90%) reported
falling at 3 month follow up. Between January and June 2016, 103
out of 602 patients (17.11%) reported falling at 3 month follow up.
Since beginning the fall prevention class in October 2015, nine of
the ten following months have had a fall average below the
facility’s historical average of 23%. There has also been a down-
ward trend in patients reporting falls after discharge during this
time.
Conclusions:
Implementation of a fall prevention and education class
has led to a decrease in patient falls post discharge. Class offerings are
held biweekly for rehabilitation patients and their family members.
Reinforcement of preventative practices by the entire staff improved
adherence to the program.
Level of Evidence:
Level IV
Poster 163:
Calf Measurements as Indicator for Deep Vein
Thrombosis: A Quality Improvement Project
Amy H. Ng, MD MPH (University of Texas MD Anderson Cancer Center)
Disclosures:
Amy Ng: I Have No Relevant Financial Relationships To
Disclose
Objective:
We aim to implement a nursing driven physical assessment
during the initial admission encounter in cancer patients admitted to
inpatient rehabilitation that will improve documented DVT screening
assessment to 75% within 1 year. Additionally, we aim to see if calf
circumference measurements at admission to inpatient rehabilitation
unit will have an impact on DVT detection at admission to the reha-
bilitation unit.
Design:
Prospective Study and Retrospective Chart Review.
Setting:
Cancer rehabilitation patients admitted to inpatient reha-
bilitation unit at a tertiary cancer center.
Participants:
A total of 373 patients were admitted to the inpatient
cancer rehabilitation unit from 4/1/15 to 4/1/16.
Interventions:
Not Applicable.
Main Outcome Measures:
Collected measurements included compli-
ance (if calf measurement were recorded), if there was a difference of
greater than 3 cm between the two calves, and if a venous Doppler
was ordered for the affected leg and if the outcome of the Doppler
study was positive for DVT.
Results:
A total of 373 patients were admitted to the inpatient
cancer rehabilitation unit. Only 6 patients or 1.6% did not have
calves measured. We achieved a good compliance rate, with 98.4%
compliance to measurement of calves by the admitting nursing
staff. Only 1 patient had difference in calf measurement and clin-
ical exam significant to warrant a venous Doppler ultrasound. No
positive identification of DVT resulted in the use of calf measure-
ment technique.
Conclusions:
This quality improvement project increased surveillance
of clinical detection of DVT. It also increased awareness of clinical
staff, nurses, and therapists to appropriately identify leg swelling as
an earlier indicator of DVTs.
Level of Evidence:
Level IV
S184
Abstracts / PM R 9 (2017) S131-S290