Reducing 30-Day Hospital Readmission Rate in Left Ventricular Assist Device Patients with a Structured Readmission Improvement Plan

2017 ◽  
Vol 36 (4) ◽  
pp. S197-S198
Author(s):  
D.B. Sims ◽  
A. Luke ◽  
S. Rangasamy ◽  
E. Borukhov ◽  
O. Saeed ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Left Ventricular ◽  
Day Hospital ◽  
Assist Device ◽  
Ventricular Assist ◽  
Improvement Plan ◽  
Hospital Readmission Rate ◽  
Left Ventricular Assist

scholarly journals Present-Day Hospital Readmissions after Left Ventricular Assist Device Implantation: A Large Single-Center Study

2015 ◽  
Vol 42 (5) ◽  
pp. 419-429 ◽  
Author(s):  
Ruben E. Hernandez ◽  
Steve K. Singh ◽  
Dale T. Hoang ◽  
Syed W. Ali ◽  
MacArthur A. Elayda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Readmission Rate ◽  
Left Ventricular ◽  
Unplanned Readmission ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Left ventricular assist device (LVAD) therapy improves survival, hemodynamic status, and end-organ perfusion in patients with refractory advanced heart failure. Hospital readmission is an important measure of the intensity of LVAD support care. We analyzed readmissions of 148 patients (mean age, 53.6 ± 12.7 yr; 83% male) who received a HeartMate II LVAD from April 2008 through June 2012. The patients had severe heart failure; 60.1% were in Interagency Registry for Mechanically Assisted Circulatory Support class 1 or 2. All patients were observed for at least 12 months, and readmissions were classified as planned or unplanned. Descriptive and multivariate regression analyses were used to identify predictors of unplanned readmission. Twenty-seven patients (18.2%) had no readmissions or 69 planned readmissions, and 121 patients (81.8%) had 460 unplanned readmissions. The LVAD-related readmissions were for bleeding, thrombosis, and anticoagulation (n=103; 49.1%), pump-related infections (n=60; 28.6%), and neurologic events (n=28; 13.3%). The readmission rate was 2.1 per patient-year. Unplanned readmissions were for comorbidities and underlying cardiac disease (54.3%) or LVAD-related causes (45.7%). In the unplanned-readmission rate, there was no significant difference between bridge-to-transplantation and destination-therapy patients. Unplanned readmissions were associated with diabetes mellitus (odds ratio [OR]=3.3; P=0.04) and with shorter mileage from residence to hospital (OR=0.998; P=0.046). Unplanned admissions for LVAD-related sequelae and ongoing comorbidities were common. Diabetes mellitus and shorter distance from residence to hospital were significant predictors of readmission. We project that improved management of comorbidities and of anticoagulation therapy will reduce unplanned readmissions of LVAD patients in the future.

scholarly journals Performance Improvement to Decrease Readmission Rates for Patients With a Left Ventricular Assist Device

2018 ◽  
Vol 28 (2) ◽  
pp. 184-188 ◽  
Author(s):  
Jackeline Iseler ◽  
John Fox ◽  
Kelly Wierenga
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Readmission Rate ◽  
Transitional Care ◽  
Left Ventricular ◽  
Readmission Rates ◽  
Assist Device ◽  
Ventricular Assist ◽  
Care Nurse ◽  
Left Ventricular Assist

Background: The 30-day readmission rate for patients with a left ventricular assist device implantation at a large, urban, Midwest hospital system (from October 2013 to September 2014) was estimated at 32.1%. Problem Statement: Readmission rates were a concern at this facility. Review of the readmissions, change in practice, and home expectations of patients and families have identified an opportunity to improve the transitions of care for this left ventricular assist device (LVAD) program. Therefore, the purpose of this project was to evaluate the effectiveness and feasibility of a transitional care model (TCM) for care of patients with left ventricular devices. Methods: Ten patients were enrolled in the pilot that was implemented in June 2015. A transitional care nurse trained to support patients with ventricular assist devices was used to facilitate patient flow. The goal was to create an individualized plan for the development or improvement of self-management skills to decrease readmission rates. The transitional care nurse collaborated with the ventricular device team. Outcomes: The 30-day readmission rate during the pilot was 14.3% compared to the previous annual overall rate of 42.6%. Implications for Practice: Based on these results, further research is recommended into interventions consistent with the TCM to advance care coordination and to facilitate care transition in the this fragile patient population.

Ultrastructural observations of the aorta of calves implanted with a mechanical left ventricular assist device

1990 ◽  
Vol 48 (3) ◽  
pp. 834-835
Author(s):  
J P Cassella ◽  
V Salih ◽  
T R Graham
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Aortic Tissue ◽  
Assist Device ◽  
Ventricular Assist ◽  
Transmission Electron ◽  
Left Ventricular Assist ◽  
Preliminary Study

Left ventricular assist systems are being developed for eventual long term or permanent implantation as an alternative to heart transplantation in patients unsuitable for or denied the transplant option. Evaluation of the effects of these devices upon normal physiology is required. A preliminary study was conducted to evaluate the morphology of aortic tissue from calves implanted with a pneumatic Left Ventricular Assist device-LVAD. Two 3 month old heifer calves (calf 1 and calf 2) were electively explanted after 128 days and 47 days respectively. Descending thoracic aortic tissue from both animals was removed immediately post mortem and placed into karnovsky’s fixative. The tissue was subsequently processed for transmission electron microscopy (TEM). Some aortic tissue was fixed in neutral buffered formalin and processed for routine light microscopy.

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