1942. Expansion of Outpatient Parenteral Therapy Program with Addition of Advanced Practice Providers Can Lead to Reduced Readmission Rates
Session: Poster Abstract Session: Clinical Practice Issues: OPAT
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Anderson-APPOPAT-2018.pdf (182.0 kB)
  • Background: The addition of Advanced Practice Providers (APPs) such as Nurse Practitioners or Physician Assistants as hospital-based service providers has been shown to increase efficiency of care, provide for better continuity of care across the inpatient and outpatient settings, and facilitate interdisciplinary collaboration. As health care systems attempt to not only increase access to care but also improve quality, the addition of APPs is becoming an option to meet division-specific goals. To decrease readmissions and increase access to care for patients discharged on intravenous (IV) antibiotics and in the Outpatient Parenteral Antibiotic Therapy (OPAT) Program, the Division of Infectious Diseases at UPMC Presbyterian hired two APPs in early 2017. Our aim is to compare readmission and follow-up rates from the time before expansion of the program with APPs to after expansion.

    Methods: We completed a retrospective study of all OPAT patients seen by any Infectious Diseases (ID) provider (MD or APP) n the period from January to May 2017 (prior to APP outpatient clinics with OPAT patients) and in the period from January to February 2018. The total number of patients seen by an ID provider and the 30-day readmission rates were collected and evaluated. A comparison of proportions was done with a two-tailed z-test for the percentage of readmissions prior to program expansion compared to the percentage of readmissions after program expansion.

    Results: Following the expansion of the OPAT program with the addition of two APPs in 2017, there was a decrease, from 14.7% to 9.6%, in 30-day readmissions for all patients who were seen for follow-up (p = 0.0461, 95% CI 0.0672–9.3164). The percentage of patients who were seen for follow-up increased after expansion of the program from 29.5% to 39.3% (p = 0.0051, 95% CI 2.8714–16.9153).

    Conclusion: Expansion of the OPAT program within the Division of Infectious Diseases at UPMC with the addition of two APPs has significantly increased access to care and significantly decreased 30-day readmissions when the patient was seen for follow-up by an ID provider (MD or APP).

    Joshua Wingfield, DNP1, Maighdlin Anderson, DNP1 and Kathleen Sheridan, DO2, (1)Department of Medicine, Division of Infectious Disease, University of Pittsburgh Medical Center, Pittsburgh, PA, (2)University of Pittsburgh, School of Medicine, Pittsburgh, PA

    Disclosures:

    J. Wingfield, None

    M. Anderson, None

    K. Sheridan, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.