A Quality Improvement Plan to Reduce 30-Day Readmissions of Heart Failure Patients

Abstract

An evidence-based quality initiative to decrease heart failure 30-day readmissions was implemented at a hospital in Florida. Heart failure education and postdischarge telephone contact were provided to patients determined to be at high risk of readmission using risk stratification tools. The rate during the project decreased 13% as compared to the same time period in the previous year and 8.5% from the 2012 year to date rate.

Transitional Care Interventions for Patients with Heart Failure: An Integrative Review

“…All studies conducted transitional care interventions for patients with HF. Regarding research design, there were 10 RCTs [16,21,22,24,28,29,32,33,36,38], two quasi-experiments [23,40], two pre-and post-tests [17,26], six cohort studies [18,19,27,34,35,37], and five prospective studies [20,25,30,31,39]. Although it was necessary to establish controls to verify the effects of transitional care interventions, in six of the 25 studies [17][18][19][20]26,39], there was no comparative control group set up to verify the effectiveness of transitional care interventions.…”

“…In total, 17 of the 25 studies were conducted in North America [17-22, 24-27,29,31,34,37-40], three in Europe [23,30,35], three in China [16,28,32], and two in Iran [33,36]. Thirteen of the 25 studies did not report racial ethnicity [16,20,21,23,24,26,28,30,32,33,35,36,38]. The sample size ranged from 38 [24] to 3462 [19], and the average patient age was between 65 [36] and 82 years [27,30].…”

“…The sample size ranged from 38 [24] to 3462 [19], and the average patient age was between 65 [36] and 82 years [27,30]. The percentage of males ranged from 35% [34] to 97% [37], but three studies [20,26,32] did not report sex.…”

“…Subjects presented with various HF types: two studies reported on end-stage HF [28,32], three on chronic HF [16,23,33], two on congestive HF [21,37], one on decompensated HF [29], and the remaining 17 on HF [17][18][19][20]22,[24][25][26][27]30,31,[34][35][36][38][39][40]. To identify HF severity, we considered the New York Heart Association (NYHA) class and left ventricle ejection fraction (LVEF).…”

“…One study reported B-type natriuretic peptide level >200 ng/mL [25], and two studies reported HF with reduced or preserved ejection fraction [17,18]. The remaining 12 studies [20,23,26,27,[30][31][32][33]35,[37][38][39] did not report the participants' severity of HF.…”