{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:22:43Z","timestamp":1790947363463,"version":"4.1.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Our aim was to determine whether a standardized Transitional Stroke Clinic (TSC) led by nurse practitioners could reduce 30-day and 90-day readmissions for stroke or transient ischemic attack patients discharged home.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Phase I consisted of nurse practitioners calling only high-risk patients discharged home within 7 days and performing an office visit within 2 to 4 weeks of discharge. Phase II consisted of all patients discharged home receiving both a 2-day follow-up phone call by a registered nurse and a follow-up visit with a nurse practitioner within 7 to 14 days. Differences in process metrics and readmissions across the 2 phases and overall were assessed. Increasing complexity with multiple chronic conditions (diabetes mellitus, coronary artery disease, and congestive heart failure) was represented in a continuous variable from 0 to 3. Multivariable logistic regression models for 30-day and 90-day readmissions were performed with adjustment for National Institutes of Health Stroke Scale (NIHSS) and previous hospitalizations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              From October 2012 through September 2015, 510 patients were enrolled. From phase I to II, a higher proportion of follow-up calls were made and days from discharge to TSC decreased. Patients readmitted within 30 days were less likely to show for TSC visits (60.85% versus 76.3%;\n              <jats:italic>P<\/jats:italic>\n              =0.021). Multivariable modeling showed that TSC visit was associated with a 48% reduction in 30-day readmission (odds ratio, 0.518; 95% confidence interval, 0.272\u20130.986), whereas multiple chronic conditions and previous stroke\/transient ischemic attack increased the risk. TSC visit did not impact 90-day readmissions.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Evaluation in a nurse practitioner\u2013led structured clinic is a model that may reduce readmissions at 30 days for stroke patients discharged home.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.115.012524","type":"journal-article","created":{"date-parts":[[2016,4,29]],"date-time":"2016-04-29T06:20:59Z","timestamp":1461910859000},"page":"1599-1604","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":91,"title":["Reducing Readmissions After Stroke With a Structured Nurse Practitioner\/Registered Nurse Transitional Stroke Program"],"prefix":"10.1161","volume":"47","author":[{"given":"Christina","family":"Condon","sequence":"first","affiliation":[{"name":"From the Department of Neurology, Wake Forest Baptist Medical Center, Winston Salem, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lycan","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Wake Forest Baptist Medical Center, Winston Salem, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Duncan","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Wake Forest Baptist Medical Center, Winston Salem, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Bushnell","sequence":"additional","affiliation":[{"name":"From the Department of Neurology, Wake Forest Baptist Medical Center, Winston Salem, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.783688"},{"key":"e_1_3_4_3_2","first-page":"494","article-title":"Monitoring and improving acute stroke care: The North Carolina Stroke Care Collaborative.","volume":"73","author":"Rosamond W","year":"2012","unstructured":"Rosamond W, Johnson A, Bennett P, O\u2019Brien E, Mettam L, Jones S, et al.. Monitoring and improving acute stroke care: The North Carolina Stroke Care Collaborative. N C Med J. 2012;73:494\u2013498.","journal-title":"N C Med J"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001038"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.190"},{"key":"e_1_3_4_6_2","unstructured":"Horwitz L Partovian C Lin Z Herrin J Grady J Conover M et al.. Hospital-Wide (All-Condition) 30-Day Risk-Standardized Readmission Measure. Draft Measure Methodology Report. Baltimore MD: Centers for Medicare and Medicaid Services; 2011."},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.05.005"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.1608"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/JNN.0000000000000143"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-6-201209180-00004"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2014.00219"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0041"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1062860614535838"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.3.656"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003165"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2004.52202.x"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.115.012524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:36:46Z","timestamp":1715611006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.115.012524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1161\/STROKEAHA.115.012524"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.115.012524","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6]]},"assertion":[{"value":"2015-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}