Director’s paper shares strategy to reduce hospital readmissions

A nursing director at Pennsylvania College of Technology co-authored a piece, published recently in Rehabilitation Nursing Journal, that reveals a drop in hospital readmission rates among rehabilitation patients when nurses implement a “teach-back” patient education strategy.

Kelly T. Bidlespacher, director of nursing-bachelor’s and graduate degrees at Penn College, pursued the evidence-based practice improvement project as part of her doctoral studies. The resulting paper, titled “The Effect of Teach-Back on Readmission Rates in Rehabilitation Patients,” was published in the March/April 2024 issue of RNJ, the bimonthly, peer-reviewed journal of the Association of Rehabilitation Nurses. The article was co-authored by David C. Mulkey, of Grand Canyon University.

“Rehabilitation patients and their caregivers need extensive training and a complete understanding of their care plan to manage their care at home,” Bidlespacher wrote. “Clinicians often underestimate their patients’ learning needs and overestimate their ability to communicate effectively with patients.”

In the acute care hospital where Bidlespacher implemented the project, nurses were providing both printed and verbal instructions to patients, but they could not be sure whether patients fully understood the information.

To help reduce the number of discharged rehabilitation patients who were readmitted to the hospital within 30 days, Bidlespacher worked with hospital staff to implement the teach-back method, as outlined in the Agency for Healthcare Research and Quality’s Health Literacy Universal Precautions toolkit.

The teach-back strategy encourages patients to explain, in their own words, the education they have received.

“This education may include disease management, medication and self-care,” Bidlespacher wrote. “Explaining the information in their own words allows patients to demonstrate what they have heard and received and how they comprehend the information regarding their medical care and needs.”

Nurses in the rehabilitation unit were taught how to use the teach-back method.

Thirty-day readmission rates dropped from 11% during the eight weeks prior to implementing the teach-back method to 6% during the eight weeks following implementation – a difference of 45%.

“The teach-back method, by its very nature, empowers patients,” Bidlespacher wrote. “When they can articulate their understanding of their care needs, it can foster a sense of ownership in their health outcomes. Rehabilitation nurses can further this empowerment by providing consistent feedback and encouragement.

“A 45% decrease in the 30-day readmission rate suggests that when patients are well-informed about their health conditions and care regimen, they are more likely to adhere to prescribed treatments and recognize potential complications early on, potentially reducing the need for readmission.”

Thirty-day readmission rates are tracked as a national quality measure by the Center for Medicare & Medicaid Services.

Bidlespacher holds a Doctor of Nursing Practice and a Master of Science in Nursing, both from Grand Canyon University, and a post-master’s certificate in nursing education from University of Phoenix.

The Trout Run native holds three degrees from Penn College: a bachelor’s degree in nursing (2012), an associate degree in nursing (2007), and an associate degree in health arts: practical nursing emphasis (2006).

She began her Penn College employment as an adjunct faculty member in 2019. She then served as the clinical director of nursing at the college before being appointed to her current position as director of the college’s bachelor’s and graduate-level nursing degrees.

Previously, Bidlespacher was a professional care manager for UPMC Williamsport, a director and clinical manager for Bayada Pediatrics, and a nurse in The Birthplace & Pediatrics for the former Susquehanna Health (now UPMC Williamsport).

She is a member of the Sigma Theta Tau International Honor Society of Nurses and a past member of the Society of Pediatric Nurses.

To learn more about Penn College’s nursing degrees, which range from associate degrees to a post-master’s certificate, call 570-327-4525.

For information about Penn College, a national leader in applied technology education, email the Admissions Office or call toll-free 800-367-9222.