Keeping the care team in place after the patient goes home.
Close to 38% of ostomy patients are back in the emergency room or readmitted within 90 days of surgery — among the steepest readmission rates in any surgical group, and most of it traces to dehydration and skin complications that never had to happen.
Most of it is avoidable. What drives it is a shortage of wound, ostomy, and continence nurses, and the gap that opens when the hospital team that trained the patient hands off to the home-health team taking over.
readmitted or return to the ER within 90 days of surgery
UOAA; Fish et al.
BridgeCare LA's Specialized Ostomy Aftercare Program (S.O.A.P.) closes that gap head-on. Certified ostomy care nurses, registered dietitians, and physical therapists stay with the patient across both the hospital and home-health phases — looking at stoma photos as they come in so a skin problem gets handled before it turns into an ER visit, walking new ostomates through the major dietary adjustments their surgery calls for, and coaching a structured exercise routine that lowers the risk of parastomal hernia — a complication that reaches 33–44% within the first year and up to 50% by seven years when aftercare is thin.
Through the first three to six months after surgery — and beyond that when the physician calls for it — patients can reach their care team any day by phone, text, or email, and every touchpoint flows back into the ordering physician's EMR.
Patients get real support through the hardest stretch of adjusting to life with an ostomy — and the physicians and health systems behind them sidestep the readmissions that would otherwise define this population.
Deploy this program across Louisiana.
Talk to BridgeCare LA about bringing Ostomy Aftercare (S.O.A.P.) to your practice or health system.
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