(SALT LAKE CITY)—Hospital readmissions following surgery add millions of dollars a year to the nation's health care bill and often occur when physicians don't communicate well with each other or their patients. The University of Utah recognizes the impact poor communications has on surgical patients and wants to improve their outcome. In the next nine months, University of Utah researchers are going to address this issue by enlisting patients to identify problems they experienced in communication and care coordination before and after surgery.
Led by vascular surgeon Benjamin Brooke, M.D., Ph.D., assistant professor of surgery, the researchers are forming a network of up to 250 patients from rural and urban areas in Utah and surrounding states that have experienced surgical care at hospitals such as University of Utah Health Care. "We'll use their experiences to explore where major problems exist in surgical care coordination, including gaining access to surgical specialists and maintaining effective follow-up care," Brooke says. "We're trying to ensure that we're not creating gaps in care that arise from miscommunication or lack of communication."
The Patient-Centered Outcomes Research Institute (PCORI), a Washington, D.C., group that advocates for improved communication between patients and providers resulting in better-informed health care decisions, is funding the project with $15,000. Patient involvement in studies such as this one is integral to PCORI's mission, and the institute awarded funding for projects to approximately 28 percent of applicants.
Before, during and after surgery, a number of providers, case consultants and other health care workers see patients. However, as more people become involved, the possibility of miscommunication increases, sometimes resulting in preventable problems that send people back in the hospital following an operation. This happens, for example, when post-surgery instructions aren't communicated clearly to patients, their primary care providers, home health workers or skilled nursing facilities or when prescription medications are changed after surgery without the patient's primary care physician being informed.
This risk is particularly true with surgery patients who have many medical issues, such as heart disease and diabetes, or who take a lot of prescription medications, according to Brooke. But mix-ups can happen with just about any surgery patient.
"These issues are affecting quality of care now, and this is something that applies to all surgical areas," he says. "We want to find patients who have a true interest in this issue and will give us insightful information."
Putting together the network and gathering information from the patients will take about nine months, during which Brooke and others will meet with small groups of patients throughout the state to identify key areas for improvement. He and his research colleagues, including Sam Finlayson, M.D., M.P.H., U of U professor and chair of surgery, also are looking for medical providers who refer patients to University of Utah Health Care or see them after surgery to join the discussions with their experiences.
People who have had surgery or taken care of someone who had surgery and want to learn more about the study can call 801-581-8409 for information.
Once they have identified common problems in surgical care coordination, Brooke and colleagues plan to look at inefficiencies in the care coordination process and then identify potential solutions. "It's really a process of how patients get handed off from one provider to another," he says. "There is a big opportunity for quality improvement."