Visit from a nurse practitioner can ease transition from hospitalization to primary care

A meeting with a nurse practitioner prior to discharge could improve communication between hospital staff and primary care providers, easing the transition after hospitalization and improving patient outcomes.

Katie Wingate, a nurse practitioner at Kernersville Primary Care in North Carolina with a focus in elderly patients, piloted a program designed to close the gap between the hospital and primary care. The 10 patients in the pilot underwent a three-step discharge process, which included a visit from a nurse practitioner during their hospital stay, Wingate told Medscape Medical News.

The nurses would review patient charts, answer patient questions about care plans and discuss the process for post-discharge follow-up, she said. Within two days of discharge, the nurse would call the patient to schedule a follow-up appointment set between seven and 14 days after discharge.

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Though the pilot is in a small cohort for now, the results have been promising: None of the patients were readmitted to the hospital within 30 days of discharge. The only downside was it took the nurses away from their primary care practices for certain windows, but follow-up appointments for the patients in the pilot went much more smoothly as there was already familiarity with what happened during hospitalization.

"For me, that was the biggest success, because it puts clinical significance to the whole thing," Wingate said.

Wingate presented the findings at the American Association of Nurse Practitioners 2017 Conference.

Expanding the role of advanced practice nurses has been floated as a solution to the healthcare industry’s physician shortage. Some smaller hospitals are employing nurse practitioners as hospitalists, and the Department of Veterans Affairs has taken the approach to ensure more timely access to care—though doctors and nurses are split on the issue.

Though clinicians are sharply divided on the issue, research has suggested the doctors and nurse practitioners are equally likely to offer low-quality patient care. As the issue is contentious, advanced practice nurses, like clinical nurse specialists, are deployed in a variety of roles in a healthcare organization, but few are allowed to fully practice.