Impact of care coaching on hospital length of stay, readmission rates, postdischarge phone calls, and patient satisfaction after bariatric surgery.
BACKGROUND
Bariatric surgery is well established as an effective means of treating obesity; however, 30-day readmission rates remain high. The Bariatric Care Coaching Program was developed in response to a perceived need for better communication with patients upon discharge from hospital and prior to being seen at their first postoperative visit. The lack of communication was apparent from the number of patient phone calls to clinic and readmissions to hospital.


OBJECTIVE
The aim of this study was to evaluate the impact of the care coaching program on hospital length of stay (LOS), readmission rates, patient phone calls, and patient satisfaction.


METHODS
The study was conducted at The Ohio State University Wexner Medical Center.


METHODS
A retrospective review was conducted on patients who had primary bariatric surgery from July 1, 2013 to June 30, 2015. The control group included patients who underwent surgery from July 1, 2013 to June 30, 2014, before development of the program, and the experimental group was composed of patients who received care coaching from July 1, 2014 to June 30, 2015. Demographics, postoperative complications, LOS, clinic phone calls, and hospital readmissions, prior to the first postoperative visit, were collected from medical records. Patient satisfaction scores were collected from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey [HCAHPS]. Differences between study groups were assessed and P values <0.05 were considered statistically significant.


RESULTS
There were 261 and 264 patients in the care-coach and control groups, respectively. The care-coached group had fewer patients with intractable nausea/vomiting (P = .0164) and a shorter mean LOS (P = .032). Subgroup analysis indicated that the difference in LOS was evident for laparoscopic sleeve gastrectomy (P = .002). There was no difference in readmission rates (P = .841) or phone calls to clinic (P = .407). HCAHPS scores demonstrated an improvement in patients' perception of communication regarding medications (59th versus 27th percentile), discharge information (98th versus 93rd percentile), and likelihood of recommending the hospital (85th versus 74th percentile).


CONCLUSIONS
The Bariatric Care Coaching Program is an important new adjunct in the care of our bariatric inpatients. It has had the greatest impact on postoperative nausea/vomiting, LOS for sleeve gastrectomy, and patient satisfaction. Further studies are needed to evaluate how to use this program to reduce readmission rates and phone calls to the clinic.
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Anahita
A
Jalilvand
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Andrew
A
Suzo
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Melissa
M
Hornor
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Kristina
K
Layton
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Mahmoud
M
Abdel-Rasoul
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Luke
L
Macadam
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Dean
D
Mikami
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Bradley
B
Needleman
The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: Sabrena.Noria@osumc.edu.
Sabrena
S
Noria
D000328:Adult; D000359:Aftercare; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D003142:Communication; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D009820:Ohio; D010351:Patient Discharge / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010359:Patient Readmission / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011182:Postoperative Care / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D015397:Program Evaluation; D012189:Retrospective Studies; D013689:Telephone / Q000706:statistics & numerical data