Utilization of a multidisciplinary team to reduce the rate of hospital readmissions in high-risk heart failure patients at a community teaching hospital: The pharmacist's role in transitions of care

2019 ◽  
Vol 2 (3) ◽  
pp. 281-287 ◽  
Author(s):  
Maria M. Thurston ◽  
Tze-chun Vivian Liao ◽  
Tanna Lim ◽  
Teresa Pounds ◽  
Pamela M. Moye-Dickerson
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Teaching Hospital ◽  
Multidisciplinary Team ◽  
Hospital Readmissions ◽  
Transitions Of Care ◽  
Heart Failure Patients ◽  
Community Teaching

scholarly journals Predictors of diuresis response to levosimendan administration in patients with acute heart failure

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
J Plonka ◽  
J Bugajski ◽  
M Plonka ◽  
A Tycinska ◽  
M Gierlotka
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Acute Heart Failure ◽  
Clinical Status ◽  
Older Age ◽  
Analysis Model ◽  
Heart Failure Patients ◽  
Positive Effects ◽  
Pulmonary Hemodynamic ◽  
Recent Acute Myocardial Infarction

Abstract Funding Acknowledgements Type of funding sources: None. Levosimendan, a calcium sensitizer and potassium channel-opener, is appreciated  for its effects on systemic and pulmonary hemodynamic and for the relief of symptoms in acute heart failure (AHF). Positive effects of levosimendan on renal function have been also described. The aim of the present analysis was to assess the predictors of the diuresis response to levosimendan administration in high risk acute heart failure patients. Methods. We analysed 34 consecutive patients admitted with high risk AHF to one centre and treated in intensive cardiac care unit. Levosimendan was administered on top of other treatment as a 24-hour infusion of 12.5 mg total dose except for 7 patients (1 patient - terminated earlier due to intolerance, 5 patients – 48h infusion, 1 patient - 72h infusion). Decision of levosimendan administration was based on clinical status and left to attending physician. Diuresis and diuretic dosage before (24 hours) and after levosimendan infusion (48 hours) were taken into account for the present study. Results. The AHF was primary of cardiac origin in all patients. In 6 (18%) it was due to recent acute myocardial infarction. In-hospital mortality was 24%. Median length of hospitalization was 26 days (range 6 to 107 days). Mean age of the patients was 66 ± 12 years, 25 (74%) were men. Mean INTERMACS score was 3.4 ± 1.4 with wet-cold clinical profile present in 13 (38%) of patients. Mean left ventricle ejection fraction (LVEF) was 27 ± 13%, mean NTproBNP was 17176 ± 12464 pg/ml, and mean eGFR 48 ± 22 ml/min/1.73m2. At the time of levosimendan administration patients had background treatment with catecholamines (mean number per patient 1.4 ± 1.1, range 0-3) and with diuretics (mean dosage of furosemide 167 ± 102 mg/24h, range 20-500). 48-hours diuresis after levosimendan administration varies from 950 to 11300 ml (mean 4307 ± 2418 ml). It was significantly lower in patients with cold-wet profile (2646 ± 1335 vs. 5335 ± 2381 ml in other clinical profiles, p = 0.0002). Additionally, 48-hour diuresis was negatively correlated with age (r=-0.46, p = 0.0062) and the number of background catecholamines (r=-0.47, p = 0.0047), and not significantly with the furosemide dosage (r=-0.28, p = 0.10) – figure. No association with diuresis was found for LVEF, NTproBNP, and eGFR. In multiple regression analysis (model R2 = 0.63, p = 0.0085) both older age (p = 0.026) and cold-wet profile (p = 0.0074) were significant predictors of poor diuresis after levosimendan administration. Conclusion. Older age and cold-wet profile were significant predictors of poor diuresis response to levosimendan administration in high risk acute heart failure patients. Although concomitant catecholamines and high diuretic dosage use cloud also be markers of non-responders to levosimendan in terms of diuresis. Abstract Figure

Redefining Hospital Readmissions to Better Reflect Clinical Course of Care for Heart Failure Patients

2007 ◽  
Vol 22 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Lin Guo ◽  
Eugene S. Chung ◽  
Donald E. Casey ◽  
Richard Snow
Keyword(s):  
Heart Failure ◽  
Clinical Course ◽  
Hospital Readmissions ◽  
Heart Failure Patients

scholarly journals Outpatient Diuretic Infusion Clinic: A Home for High Risk Heart Failure Patients

2018 ◽  
Vol 24 (8) ◽  
pp. S129
Author(s):  
Justin D. Roberts ◽  
Amanda Gerberich ◽  
Kathleen Makkar ◽  
Lisa Rathman
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Heart Failure Patients

27 Heart Rate Control in High Risk Heart Failure Patients

Heart ◽  
2015 ◽  
Vol 101 (Suppl 4) ◽  
pp. A15.1-A15
Author(s):  
Sarah Burgess ◽  
Lucy Cornthwaite
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
High Risk ◽  
Rate Control ◽  
Heart Rate Control ◽  
Heart Failure Patients

Application of a Marketing Concept to Patient-Centered Care: Co-Producing Health With Heart Failure Patients

2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Robert Leone ◽  
Charles Walker ◽  
Linda Curry ◽  
Elizabeth Agee
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Patient Centered Care ◽  
Future Research ◽  
Marketing Concept ◽  
Patient Centered ◽  
Heart Failure Patients ◽  
Hospital Units ◽  
Effective Discharge ◽  
Centered Care

Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of ‘one size fits all,’ a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients.

Association of post-discharge specialty outpatient visits with readmissions and mortality in high-risk heart failure patients

2019 ◽  
Vol 212 ◽  
pp. 101-112 ◽  
Author(s):  
Daniel L. Edmonston ◽  
Jingjing Wu ◽  
Roland A. Matsouaka ◽  
Clyde Yancy ◽  
Paul Heidenreich ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Post Discharge ◽  
Heart Failure Patients ◽  
Outpatient Visits
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