Abstract 4074: The Effect of Heart Failure Trained Advocates on 30 and 60 day readmissions
Background: Randomized clinical trials and observational studies have demonstrated the effect of multidisciplinary teams on heart failure readmissions. We report on the effect of heart failure trained nurses (Heart Failure Advocates) on readmission risk and costs during readmissions.
Methods and Results: Catholic Healthcare Partners (CHP) placed Heart Failure Advocates at 2 hospitals as part of an AHRQ funded initiative. Readmission rates and LOS at these 2 hospitals in Heart Failure Advocate supervised populations (n=311) versus usual care (control, n=716) were compared. Both populations were identified using ICD-9 codes designating patients admitted for heart failure. The Heart Failure Advocate supervised patients were tracked for readmission occurring after their enrollment date (first post-hospital contact). Control patients were tracked for readmission after the first admission during the time frame. All admissions for 2004 and 2005 at the 2 hospitals were used for analysis. The interaction of heart failure patients with a Heart Failure Advocate was associated with a reduction in 30 and 60 all cause readmission and 30-day heart failure readmission. (Table 1⇓) Costs associated with readmissions were lower in the advocate supervised patients. (Table 2⇓)
Conclusions: The use of a single person (heart failure advocate) coordinating care for these patients with chronic disease is associated with a reduction in readmission risk. Further research into pre and post enrollment readmissions and into barriers to use of heart failure advocates will be completed.