Partnership across transitions to improve outcomes in the lower extremity total joint population
Title
Partnership across transitions to improve outcomes in the lower extremity total joint population
Creator
Ketchum, Amy L.
Description
Ketchum, Amy L.
Purpose/Objectives: Given the estimated growth in Lower Extremity Total Joint (LETJ) patients in the United States and the urgency related to improving quality of care and creating efficiency, partnership is emerging as a critical concept related to transitions of care. There were no identified existing partnership models between acute care and post-acute care organizations within the proposed setting. Objectives for this improvement project included establishment of hospital partnership with post-acute care agencies to improve outcomes associated with the LETJ population. Description: Supported by Transitions Theory, the Clinical Nurse Specialist (CNS) utilized the Stevens Star Model of Knowledge Transformation to implement partnership strategies with multidisciplinary teams to facilitate improvement in process and outcome measures. A time series design was used to monitor outcomes for two quarters of partnership activities. Outcome: All steps recommended for developing partnership models and practice integration including innovation were facilitated by the CNS within the planned timeline. The hospital patient experience and quality measures remained at or improved from baseline and met all strategic targets. During the timeline inclusive of partnership activities, overall efficiency through episode spending was flagged as significantly below the benchmark and demonstrated improvements at time points Q4 2017 and Q1 2018. Further analysis revealed that there was a significant (p<.05) reduction in the mean hospital length of stay during the partnership activities and, in comparison, to the population. Conclusion: This quality improvement project suggests the use of structured partnership strategies between agencies improves efficiency of care for LETJ patients while maintaining quality and patient experience. Critical to this partnership is the role of the CNS to facilitate synergy between interdisciplinary and inter-agency teams through evidence-based leadership, demonstrated team progress and innovation.
Purpose/Objectives: Given the estimated growth in Lower Extremity Total Joint (LETJ) patients in the United States and the urgency related to improving quality of care and creating efficiency, partnership is emerging as a critical concept related to transitions of care. There were no identified existing partnership models between acute care and post-acute care organizations within the proposed setting. Objectives for this improvement project included establishment of hospital partnership with post-acute care agencies to improve outcomes associated with the LETJ population. Description: Supported by Transitions Theory, the Clinical Nurse Specialist (CNS) utilized the Stevens Star Model of Knowledge Transformation to implement partnership strategies with multidisciplinary teams to facilitate improvement in process and outcome measures. A time series design was used to monitor outcomes for two quarters of partnership activities. Outcome: All steps recommended for developing partnership models and practice integration including innovation were facilitated by the CNS within the planned timeline. The hospital patient experience and quality measures remained at or improved from baseline and met all strategic targets. During the timeline inclusive of partnership activities, overall efficiency through episode spending was flagged as significantly below the benchmark and demonstrated improvements at time points Q4 2017 and Q1 2018. Further analysis revealed that there was a significant (p<.05) reduction in the mean hospital length of stay during the partnership activities and, in comparison, to the population. Conclusion: This quality improvement project suggests the use of structured partnership strategies between agencies improves efficiency of care for LETJ patients while maintaining quality and patient experience. Critical to this partnership is the role of the CNS to facilitate synergy between interdisciplinary and inter-agency teams through evidence-based leadership, demonstrated team progress and innovation.
Date
2018
Publisher
Alverno College
Extent
45 pages
Language
English
Format
PDF
Type
Text
DNP Project
Subject
Hospital care--Quality control
Continuum of care--Quality control
Nurse practitioners
Rights
These materials may be used by individuals and libraries for personal use, research, teaching (including distribution to classes), or for any fair use as defined by U.S. Copyright Law.
Collection
Citation
Ketchum, Amy L., “Partnership across transitions to improve outcomes in the lower extremity total joint population,” Alverno College Library Digital Commons, accessed June 14, 2026, https://alverno.omeka.net/items/show/224.