System-Wide Improvement for Transitions After Surgery: The SWIFT Post op Program

Completed · Not applicable

Conditions studied: Colectomy, Colorectal Surgery, Ileostomy

In brief

Short-term post-operative complications after colon and rectal surgery present a known major clinical and financial burden for patients and hospitals. Focused efforts to reduce readmissions after colorectal surgery is one potentially high-yield and broad approach to address this problem since post- operative complications are the strongest predictor of readmissions. We focus on decreasing readmissions after ileostomy surgery by using a previously published intervention that prevents dehydration in the outpatient setting and decreases acute renal failure complications. We plan to introduce the SWIFT post op program for ileostomy patients at one academic and two community hospitals which are part of a single health care system, and to then randomize patients to usual care in the setting of this new program versus an aggressive compliance surveillance and improvement strategy (CSIS) strategy using study personnel. Our primary study outcome is all-cause 30-day readmission, and our secondary outcomes include patient satisfaction (CAHPS scores) and a cost-benefit analysis. We seek to create a partnership between colorectal surgeons, inpatient nurse managers and wound ostomy continence nurses (WOCN) at the three sites, linking them with outpatient nurse practitioners and physician's assistants at the respective colorectal surgery clinics who facilitate care-transition after hospital discharge.

Key facts

Study ID

NCT02543190

Run by

University of Minnesota

People needed

100

Starts

2014-10-01

Expected to finish

2016-11-11

Last updated by the study team

2017-12-29

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients who are scheduled or who undergo ileostomy alone or as part of a multiple procedure operation
• patients who have had an ileostomy in the past are eligible
• patients who have an ileostomy to address a recent surgical complication are eligible

You may not qualify if…

• Patients who have an ileostomy already in place immediately prior to the procedure (ie. revision, transposition, or parastomal hernia procedures
• patients on dialysis
• patients who require chronic TPN, IVF, or have short gut
• non-English speaking patients who do not have easy access to an appropriate interpreter.

Where it is running

• University of Minnesota Medical Center -Fairview — Minneapolis, Minnesota, United States
• Colon and Rectal Surgery Associates — Saint Paul, Minnesota, United States

Full record on ClinicalTrials.gov

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