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Using Nurse Practitioner Co-Management to Reduce Hospitalizations and Readmissions Within a Home-Based Primary Care Program

Jones, Masha G.; DeCherrie, Linda V.; Meah, Yasmin S.; Hernandez, Cameron R.; Lee, Eric J.; Skovran, David M.; Soriano, Theresa A.; Ornstein, Katherine A.

The Journal for Healthcare Quality (JHQ): September/October 2017 - Volume 39 - Issue 5 - p 249–258
doi: 10.1097/JHQ.0000000000000059
Original Article
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Abstract: Nurse practitioner (NP) co-management involves an NP and physician sharing responsibility for the care of a patient. This study evaluates the impact of NP co-management for clinically complex patients in a home-based primary care program on hospitalizations, 30-day hospital readmissions, and provider satisfaction. We compared preenrollment and postenrollment hospitalization and 30-day readmission rates of home-bound patients active in the Nurse Practitioner Co-Management Program within the Mount Sinai Visiting Doctors Program (MSVD) (n = 87) between January 1, 2012, and July 1, 2013. Data were collected from electronic medical records. An anonymous online survey was administered to all physicians active in the MSVD in July 2013 (n = 13).

After enrollment in co-management, patients have lower annual hospitalization rates (1.26 vs. 2.27, p = .005) and fewer patients have 30-day readmissions (5.8% vs. 17.2%, p = .004). Eight of 13 physicians feel “much” or “somewhat” less burned out by their work after implementation of co-management. The high level of provider satisfaction and reductions in annual hospitalization and readmission rates among high-risk home-bound patients associated with NP co-management may yield not only benefits for patients, caregivers, and providers but also cost savings for institutions.

For more information on this article, contact Masha G. Jones at mgj9001@nyp.org.

Funders: The research was supported by National Institute on Aging K01AG047923 (Dr. Ornstein) and Jewish Foundation for Education of Women (Dr. Jones). The Nurse Practitioner Co-Management Program of the Mount Sinai Visiting Doctors Program was funded by the Y.C. Ho Helen and Michael Chiang Foundation and the Fan Fox and Leslie R. Samuels Foundation.

The research was presented in a poster session at the 2014 Annual Meeting of the American Geriatrics Society.

The study sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

The authors declare no conflict of interest.

© 2017 National Association for Healthcare Quality
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