Georgetown University LogoGeorgetown University Library LogoDigitalGeorgetown Home
    • Login
    View Item 
    •   DigitalGeorgetown Home
    • Georgetown University Institutional Repository
    • Georgetown University Medical Center
    • School of Nursing and Health Studies
    • Graduate Theses and Dissertations - Nursing and Health Studies
    • View Item
    •   DigitalGeorgetown Home
    • Georgetown University Institutional Repository
    • Georgetown University Medical Center
    • School of Nursing and Health Studies
    • Graduate Theses and Dissertations - Nursing and Health Studies
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Pilot Program to Improve Transfer of Care Between Neurosurgical and Outpatient Neurology Teams Following Implantation of an Intrathecal Baclofen Pump

    Cover for Pilot Program to Improve Transfer of Care Between Neurosurgical and Outpatient Neurology Teams Following Implantation of an Intrathecal Baclofen Pump
    View/Open
    View/Open: Mitchell_georgetown_0076D_13493.pdf (598kB) Bookview

    Creator
    Mitchell, Erika
    Advisor
    Moriarty, Maureen
    ORCID
    0000-0003-0130-9707
    Abstract
    PILOT PROGRAM TO IMPROVE TRANSFER OF CARE BETWEEN NEUROSURGICAL AND OUTPATIENT NEUROLOGY TEAMS FOLLOWING IMPLANTATION OF AN INTRATHECAL BACLOFEN PUMP
     
    Erika Mitchell, M.S.N.
     
    Thesis Advisor: Maureen Moriarty, DNP
     
    ABSTRACT
     
    Current clinic procedure in a large urban hospital-based outpatient Neurology practice does not include standardized handoff communications for ITBP patients during transfer or transition of care, specifically between Neurosurgery and Neurology. The paucity of interdisciplinary communication leads to lengthy durations of time between pump implantation and outpatient follow-up, poor continuity of care, and increased potential for avoidable negative events.
     
    A new pilot workflow was developed by the researcher and implemented over a 24 week time frame. Comparison data were obtained via EMR from the same time cycle of the previous year. Metrics evaluated included average days to Neurology clinic follow-up post implantation, frequency of pre-surgical notification, and frequency of post-surgical handoff between Neurosurgical and Neurology team members. Neurology and Neurosurgical team members were asked to complete a pre/post implementation electronic survey to assess changes in perception of teamwork.
     
    Average days to Neurology follow-up post implantation decreased 31.5 days during the pilot study. This was found to be statistically significant with a p-value of 0.03. The incidence of pre-surgical notification to outpatient Neurology increased from 0% to 83.3%. The incidence of post-surgical handoff report increased from 0% to 50%. The average teamwork survey scores showed an insignificant change from a mean of 4.59 to 4.62.
     
    The pilot study aimed to implement a standardized communication workflow in an effort to decrease days to follow-up post-op, increase frequency of patient presurgical notification, increase frequency of post implantation handoff report, and evaluate for change provider interdisciplinary teamwork. Although the data did indicate a decrease in days to follow-up, improved communication and handoff frequency, the pilot workflow is not sustainable. Unanticipated culture barriers and provider time restrictions proved detrimental to the success and feasibility of the project. Changes to the workflow, including collaboration with the Medtronic ITBP representatives and pre-procedure scheduling of outpatient Neurology follow-up appointments could offer realistic and viable alternatives to achieve communication goals.
     
    Description
    D.N.P.
    Permanent Link
    http://hdl.handle.net/10822/1042858
    Date Published
    2016
    Subject
    Hand-off Communication; Interdepartmental communication; Intrathecal Baclofen Pump; Pilot study; Spasticity; Nursing; Nursing;
    Type
    thesis
    Publisher
    Georgetown University
    Extent
    43 leaves
    Collections
    • Graduate Theses and Dissertations - Nursing and Health Studies
    Metadata
    Show full item record

    Related items

    Showing items related by title, author, creator and subject.

    • Thumbnail

      Assessing the New York City Involuntary Outpatient Commitment Pilot Program 

      Steadman, Henry J.; Gounis, Kostas; Dennis, Deborah; Hopper, Kim; Roche, Brenda; Swartz, Marvin; Robbins, Pamela Clark (2001-03)
    Related Items in Google Scholar

    Georgetown University Seal
    ©2009 - 2022 Georgetown University Library
    37th & O Streets NW
    Washington DC 20057-1174
    202.687.7385
    digitalscholarship@georgetown.edu
    Accessibility
     

     

    Browse

    All of DigitalGeorgetownCommunities & CollectionsCreatorsTitlesBy Creation DateThis CollectionCreatorsTitlesBy Creation Date

    My Account

    Login

    Statistics

    View Usage Statistics

    Georgetown University Seal
    ©2009 - 2022 Georgetown University Library
    37th & O Streets NW
    Washington DC 20057-1174
    202.687.7385
    digitalscholarship@georgetown.edu
    Accessibility