Abstract 15482: Implementation of a Heart Failure Readmission Reduction Program: a Quality Improvement Study
Introduction Of all medical readmissions within 30 days, congestive heart failure (CHF) accounts for 26.9%, making it the number one cause of hospital readmissions within 30 days. There has been a substantial push to decrease rehospitalizations. To that end, our hospital launched its Smooth Transitions Equal Less Readmissions (STELR) program in November 2010.
Hypothesis We assessed the hypothesis that implementing the STELR program would lower the 30-day readmission rate and improve medical staff diagnosis, management, and treatment of heart failure, based on current standards of care.
Methods To characterize the CHF readmission population, we retrospectively reviewed charts of CHF patients who were readmitted within 30 days of an initial discharge between November 2009 and April 2010. Then all CHF patients were tracked prospectively through the STELR program from admission to discharge between November 2010 and January 2011. Data included demographics, comorbidities, documentation of symptoms, exam findings, NYHA classification, LVEF, medications, home healthcare referrals, and follow-up appointment information. Descriptive statistics and 30-day readmission rates were assessed using Microsoft Excel and SPSS software.
Results Retrospectively, 65 charts were reviewed. Prospectively, 69 patients were followed. Hospital-wide 30-day CHF readmission rates dropped from 31.78% before the STELR program to 24.27% after. The readmission rate in patients tracked through STELR was 20.6%. Chart documentation improved, including increased notation of orthopnea, weight gain and dietary indiscretion. Assessment of NYHA classification improved from 1 patient out of 65 in the retrospective group to 21 out of 69 patients in the prospective group. Home healthcare referrals increased from 32% to 56% in the retrospective and prospective cohorts, respectively; and 67% of STELR patients received education regarding their diagnosis and medications. Of the STELR patients, 54% had follow-up appointments scheduled compared to 42% prior.
Conclusions Our data indicated the STELR program decreased the hospital-wide 30-day CHF readmission rate and improved treatment and management of CHF patients. STELR patients displayed an even lower readmission rate.
- © 2011 by American Heart Association, Inc.