Impact of multicomponent intervention on hospitalized clinical patient outcomes: A pre-post study in a university hospital

J Healthc Qual Res. 2024 Nov-Dec;39(6):365-372. doi: 10.1016/j.jhqr.2024.06.003. Epub 2024 Jul 10.

Abstract

Background and objective: Hospitalization significantly interferes with the individual's well-being and it occurs both during and after the hospitalization period. Different approaches to minimize morbidity related to hospitalization and the post-discharge period have been proposed, especially to those aimed at reducing readmission rates. The aim of this study is to evaluate the effect of multicomponent intervention (MI) on operational indicators and continuity of care outcomes.

Materials and methods: A quasi-experimental study conducted in a Brazilian university hospital in order to compare the impact of the intervention with usual care. The MI was the implementation of multidisciplinary rounds, the inclusion of the role of the navigator nurse, and care transition actions with half of the Internal Medicine teams in a clinical unit of a general hospital. Adult patients hospitalized were included in 2 periods and divided in 3 groups - Group A: before the intervention; Group B: after and with MI; Group C after and without MI.

Results: A total of 2333 hospitalizations were evaluated. There was a reduction in the rate of intensive care transfers to intensive care unit (ICU) and in the length of stay (LOS). LOS, discharge before noon, and transfers to ICU improved when comparing before and after the intervention, but were not different in post-intervention groups with and without MI.

Conclusion: These results reflect the improvement of care provided by MI, an effect that could be due to cross contamination also to teams without the intervention.

Keywords: Continuidad de la atención al paciente; Continuity of patient care; Equipo de atención al paciente; Indicadores de calidad; Patient care team; Quality indicators.

MeSH terms

  • Adult
  • Aged
  • Brazil
  • Continuity of Patient Care
  • Female
  • Hospitalization
  • Hospitals, University*
  • Humans
  • Intensive Care Units
  • Length of Stay* / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Care Team
  • Patient Discharge