We investigate how patients can co-create value when transitioning care between the hospital and home after a major life altering surgery such as kidney transplant. Collaborating with health care providers at a large U.S. hospital, we adopted an intervention-based research approach to develop a standardized peer-mentoring program where former patients mentor current patients for 30 days postdischarge. We assessed the impact of the program on patient anxiety and 30-day readmissions through a randomized control trial that recruited 80 transplant patients. Our analyses of patient anxiety indicated that patients in the treatment arm experienced 3.42 points greater decrease in anxiety score over 30 days, suggesting that care transitions using mentors decreases anxiety levels among patients. Our analyses of readmissions led to an unexpected but explainable result. We found that patients in the treatment arm were at 12.6 times greater risk of readmission during the first 30 days.Exploratory analysis suggests that increased readmission may have been due to patients reporting complications sooner, which allowed them to get treated earlier. Overall, our study informs healthcare operations on how to design effective transition of care programs using cost-effective resources and offers new insights on using patient-centric metrics.
Background:There is an increasing number of patient's undergoing kidney transplantation in the United States. Kidney recipients have high occurrence of 30-day readmissions that leads to high hospital costs and decreased quality of life. Previous research found that a high level of post-transplant anxiety is correlated with increased likelihood of 30-day readmissions. The goal of this paper is to describe the study design and implementation process of a randomized control trial (RCT) using a standardized post-transplant mentoring program in order to reduce 30-day readmission and post-transplant anxiety among kidney transplant recipients.Methods/Design: A single institution RCT evaluating post-kidney transplant patient's anxiety level and readmission rates (both 30-and 90-day). The intervention group will consist of a standardized mentoring process during a four-week period following transplantation and the control group will undergo routine post-operative (PO) care. The mentors will be prior kidney-transplant recipients who will undergo a standardized training process. They will contact the intervention group at week intervals to help counsel on proper PO care and give routine advice. Objective and subjective data will be collected at week intervals for all participants over a oneyear study period.Discussion: Standardizing a post-transplant mentoring process has the possibility of improving transplant recipient quality of life, reducing post-transplant anxiety and result in fewer readmission rates.
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