Reduction of the rate of hospitalization in patients with acute coronary syndrome

Abstract

Background: Readmission of patients with Acute Coronary Syndrome (ACS) causes many problems for them and their family. This study aimed to improve the quality of care provided to patients with ACS and discover solutions to reduce the rate of readmission among them. Materials and Method: This participatory action research study was done based on Streubert and Carpenter approach. This study included 45 participants (31 patients and 14 stakeholders) and carried out in a hospital affiliated to Isfahan University of Medical Sciences, Iran, from 2013 to 2014. Solutions with high and moderate feasibility, flexibility, and suitability were implemented in each cycle until reaching <15% readmission rate. Data were analyzed using SPSS (V.16) and running descriptive and inferential statistics. Results: In this study, several actions were performed in each cycle such as assigning a free and 24-h telephone line was patients to contact nurses and face-to-face patient's education. Second cycle actions included active participation of all nurses in the education of patients and involvement of families in patient care. By carrying out the first action cycle, the readmission rate reached 35%, which was not favorable. By completing the second action cycle, the readmission rate reached 12%, which was desirable and significantly lower than the first cycle. Conclusion: Discovering possible solutions with the participation of stakeholders in therapeutic settings that have feasibility, flexibility, and suitability can lead to improved care quality and reduced readmission rate in patients with ACS, especially if the families of the patients also participate in action cycles.

Use of co‐design methodology in the development of cardiovascular disease secondary prevention interventions: A scoping review

“…Of these, 5738 articles were excluded based on the review of the title and abstract, and the full text was obtained for the remaining 154 articles. Based on the authors' assessment, 22 unique studies 28–49 published across 45 articles met the eligibility criteria and were included in this review (Figure 1).…”

“…Of the 22 included studies, 16 utilized a mixed‐method approach 28‐30,32,34,35,38,39,41‐45,47‐49 and six were qualitative 31,33,36,37,40,46 . Only one study had been published before the year 2010, 39 while the rest were published between 2014 and 2022.…”

“…One study undertaken in a hospital setting 38 involved meeting with hospital management staff to identify key services and/or staff who could act as champions for the co‐design process. One study 33 engaged nurses and nurse managers of the cardiac care unit via several informal meetings throughout the co‐design process to identify ways to address readmissions.…”

“…Of the 22 included studies, 16 utilized a mixed-method approach [28][29][30]32,34,35,38,39,[41][42][43][44][45][47][48][49] and six were qualitative. 31,33,36,37,40,46 Only one study had been published before the year 2010, 39 while the rest were published between 2014 and 2022. Multiple geographical settings were represented with the majority of studies from Australia (n = 7) and the United States (n = 4), and two studies each from the Netherlands, Sweden and the United Kingdom.…”

“…The most common approach used in the planning phase was organizing stakeholder/expert or community advisory board meetings utilized in eight studies. 31,37,38,42,[46][47][48][49] Group discussions/focus groups with participants were used in six studies 30,34,36,41,43,44 ; and four studies 28,33,35,45 ran ideas/brainstorming workshops to generate ideas/goals and devise plans on how to achieve them.…”