Transitions Of Care Nurse Effect on No-Show Clinic Rates: A Quality Improvement Project for Stroke Survivors
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Date
2025-05
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Publisher
The Ohio State University
Abstract
Background: Stroke remains a leading cause of death and disability in the United States (US). In the US, stroke systems of care (coordination of care from pre-hospital assessment to post-acute care for stroke) over the last 15 years have witnessed an increase in stroke treatment rates, resulting in stroke dropping from the third leading cause of death to the fifth in the US.
Problem: Despite improvements in acute care treatments, stroke survivors have a higher incidence of hospital readmission, recurrent stroke rates, and an increase in morbidity and mortality when they do not complete post-discharge clinic visits with a neurologist.
Intervention/Methods: This evidence-based quality improvement project involves the implementation of the transitions of care nurse (TCN) role in improving clinic appointments scheduled before discharge for stroke patients and decreasing clinic no-show rates. Pre- and post-implementation data were collected, including the percentage of patients discharged to home with a follow-up appointment scheduled before discharge and the missed appointment rate. Descriptive statistics were used to summarize and display the data.
Outcomes: This project demonstrated that the TCN role increased the number of appointments scheduled before discharge and decreased clinic no-show rates.
Conclusion: Implementing a TCN for stroke allowed the host organization to ensure that many patients' follow-up appointments were made before discharge and decreased clinic no-show rates.
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Keywords
nurse, transitions of care, navigator, stroke, missed appointments, no-show