Impact of Transdisciplinary Heart Failure Program on Readmission Rates of Patients with Heart Falure
Authors
Advisor
Date
Embargo until
Language
Book title
Publisher
Peer Reviewed
Type
Research Area
Jurisdiction
Collections
Other Titles
See at
Abstract
Problem: Heart failure (HF) is a progressive disease that requires multiple hospitalizations. The costs associated with these multiple hospitalizations imposes a serious financial burden in the U.S. and many European countries. The purpose of this capstone project was to determine if there was a significant downward trend in the HF-related and all-cause readmission rates of patients with HF who were discharged to home setting, after the initiation of a transdisciplinary HF program. Methods: The project was conducted un an adult care community teaching hospital. The program included an inpatient HF education and structured post-discharge telephone follow-up provided by HF education specialist an, and inpatient medication counseling provided by a pharmacist. A hospital database was used to collect aggregated data six months before and nine months after implementation of the HF program. A trend study design was utilized to present the readmission data during the 15-month period, which was equivalent to 15 data sets. Data sets were analyzed to determine if there was a significant change in all-cause and HF-related readmission that was due to special cause variation. Results: A hospital database was used to collect aggregated data on a total of 749 patients discharged to home setting with a primary diagnosis of HF between April 1, 2011 and June 30, 2012. The age of the patients ranged from 26 to100 years with a mean of 67.5 years. Fifty percent were males and 50% females. The mean 30-day HF related readmission rate was 9.08%, while the mean 30-day all-cause readmission rate was 21.9%. The data for HF related readmission rates and all-cause readmission rates were analyzed for significant changes due to special cause variation and revealed that there was no special-cause variation that was detected as a result of intervention. Therefore, there was no statistically significant decrease un HF-related and all-cause readmission rates after the initiation of a transdisciplinary HF program. Conclusion: This trend study on the impact of a transdisciplinary HF program did not reveal statistical significance in the reduction of 30-day HF related and all-cause readmission rates in patients with HF. However, there is a substantial evidence from previous studies that showed positive outcomes in reducing readmission rates using the interventions employed in the program such as patient education delivered by a HF educator, medication counseling delivered by a pharmacist and a structured post-discharge telephone follow-up. Therefore, the value of implementing a transdisciplinary HF program should not be discounted but a more precise implementation of the program should be carefulle defined and planned. Additional recommendations for future projects include utilization of a more reliable tool in assessing the risk of patients for readmission and the use of a risk adjustment tool.