Impact of Transdisciplinary Heart Failure Program on Readmission Rates of Patients with Heart Falure
AbstractProblem: 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.
DescriptionUniversity of Maryland, Baltimore. Doctor of Nursing Practice Scholarly Project
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/3601
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