A Strategy to Reduce Heart Failure Readmissions and Inpatient Costs

Abstract

BackgroundThe objective of this study was to evaluate the effect of a disease management intervention on rehospitalization rates in hospitalized heart failure (HF) patients.MethodsPatients treated with the TEACH-HF intervention that included Teaching and Education, prompt follow-up Appointments, Consultation for support services, and Home follow-up phone calls (TEACH-HF) from January 2010 to January 2012 constituted the intervention group (n = 548). Patients treated from January 2007 to January 2008 constituted the usual care group (n = 485).ResultsGroup baseline characteristics were similar with 30-day readmission rates significantly different (19% usual care vs. 12% for the intervention respectively (P = 0.003)). Patients in the usual care group were 1.5 times more likely to be hospitalized (95% CI: 1.2 - 1.9; P = 0.001) compared to the intervention group. A savings of 641 bed days with potential revenue of $640,000 occurred after TEACH-HF.ConclusionsThe TEACH-HF intervention was associated with significantly fewer hospital readmissions and savings in bed days.

ModelHeart: a resident-led implementation of metrics to reduce 30-day heart failure readmissions

“…Our data trends were similar to the effects found in the TEACH-HF trial 24. Also, this study demonstrates the importance of prospective validation of statistically derived metrics, in order to translate statistical derivations into real-world effects.…”

“…Prior studies on this topic have shown that proven strategies to reduce readmissions involve a combination of education and organised outpatient follow-up 24. This supports the notion that exacerbation of HF starts up to 2 weeks prior to hospitalisation, suggesting that close outpatient monitoring and intervention can stabilise patients prior to the need for hospitalisation 10 25…”

Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure

“…26 The study nurse used the “teach-back” method to ensure patient understanding. 27,28 The predischarge education also included a demonstration of how to use the remote home telemonitoring equipment and an explanation of why monitoring physiological variables is important for patients.…”

Self‐management intervention using teach‐back for people with heart failure in Vietnam: A cluster randomized controlled trial protocol

“…The teachback method is not a test of a person's knowledge; it is a way to explore how well the messages are delivered and what needs to be clarified (Agency for Healthcare Research and Quality, 2015). This method has been used to significantly improve patient satisfaction (Kelly & Putney, 2015), knowledge retention (White, Garbez, Carroll, Brinker, & Howie-Esquivel, 2013), and reduce hospital readmissions (Howie-Esquivel et al, 2015). A recent systematic review found 10 studies that used the teach-back method to deliver self-management education to patients with various chronic diseases.…”