Background: Hospital readmission rates may be influenced by the level of healthcare literacy. Patients who lack an understanding of their diagnosis and warning signs have the potential to not seek medical care in a timely manner. The information patients tend to receive upon discharge is lengthy and unclear. In addition, instructions are not standardized across the continuum of care, leading to patients receiving different education packages in different care settings. The objective of this project was to standardize patient discharge education across care providers by implementing the “STOP LIGHT” education pathway and analyzing its impact on readmission rates.
Methods: We implemented the “STOP LIGHT” pathway at one hospital in two stages: In stage 1, we identified the three highest hospital re-admission diagnoses; these were congestive heart failure, chronic obstructive pulmonary disease and sepsis. We noted the known warning signs and built a one-page STOP LIGHT education. Prior to deployment, we introduced STOP LIGHT to the care team to engage multidisciplinary physicians and RN care mangers, and to streamline educational materials provided by STOP LIGHT. At stage 2 we deployed STOP LIGHT (Nov 2016). Hospitalist nurses (HRN and TCRN) utilized the Readmissions Diagnostic Tool to track and identify reasons for readmission. Education was performed at bedside, and educational material was e-mailed to the Admissions Coordinator of patients discharged to Skilled Nursing Facilities. We tracked the number patients readmitted with one or more of the three high-risk diagnoses.
Results: We analyzed 30 day readmission rates for all patients in the pilot. Our baseline period was September 1, 2016 through November 30, 2016 (n=75). Our observation period was December 1, 2016 through February 28, 2017 (n=109). During the observation period we noted a 16.25% decrease in readmission of all patients when compared to those analyzed in the baseline period (22.6% vs 6.42%, respectively (p=0.003)).
Conclusions: Our findings suggest the “STOP LIGHT” education tool has the potential to decrease readmission rates. We believe that simplifying patient education materials to a one page format may help patients understand what symptoms to pay attention to, and consistently streamline education across the continuum of care. We noted that these educational materials could be used as a simple check list for healthcare providers to follow at bedside, and since it is low cost and easy to use, further testing and confirmatory analyses are warranted.