The following is a summary of “Reducing Ileostomy Readmissions: Using Implementation Science to Evaluate the Adoption of a Quality Improvement Initiative,” published in the December 2023 issue of Gastroenterology by Vitous, et al.
It was hard to turn scientific data into professional practice. For example, stopping illness from new ileostomies could be used as an example. Oral rehydration treatments have not been widely used by people with new ileostomies, even though there is proof that they improve electrolyte levels, kidney function markers, and hospital readmissions. No one knows what causes low uptake, but it’s likely a combination of several things. For a study, researchers used the Reach, Effectiveness, Adoption, Implementation, and Maintenance implementation science framework to find out what was getting in the way of a quality improvement initiative that aimed to reduce the number of emergency room visits and hospital readmissions for dehydrated patients with new ileostomies who used oral rehydration solutions.
Some important people were interviewed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance structure to guide the conversations. Twelve community and university hospitals in Michigan are taking part. Twenty-five important people were chosen through convenience sampling.
These people included registered nurses, nurse practitioners, nurse managers, colon surgeons, surgery students, physician assistants, and data abstractors (one to four people per site). They used the Reach, Effectiveness, Adoption, Implementation, and Maintenance approach to find, study, and name trends in qualitative content analysis. They found the following things that would make it easier for providers to join quality improvement programs: choosing winners and teaching them, making diverse teams bigger, following up with patients in an organized way, and handling long-term worries about cost and equality.
Source: journals.lww.com/dcrjournal/abstract/2023/12000/reducing_ileostomy_readmissions__using.20.aspx
