Abstract 17142: Increased Adherence to Patient Follow-up Visits within 7 dDys in Heart Failure Patients are Associated With Reduced Readmission Rates in MI and WI

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Indermohan Thethi ◽  
Kathie Thomas ◽  
Lynn Mallas-Serdynski
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Cost Savings ◽  
Medicare Reimbursement ◽  
Readmission Rates ◽  
Patient Category ◽  
Quality Programs ◽  
Get With The Guidelines

Background & Objectives: Heart failure (HF) is the leading cause of hospitalization among adults aged 65 or older. Despite advancements in medical therapy, HF readmission rates remain high. The average cost of each HF readmission is about $13,000. High rates of readmissions can lead to penalties of up to 3% of Medicare reimbursement, the reduction of costs, & the improvement of quality of care and patient outcomes, which makes reduction vital to hospitals. Having a follow up visit within 7 days of hospital discharge may help reduce HF readmissions. The objective of the abstract is to quantify the change in 7 day follow up visits and 30 day readmissions as part of the Get With The Guidelines (GWTG) HF quality improvement (QI) initiative. Methods: GWTG HF is an in-hospital quality initiative designed to improve care by promoting adherence to the latest scientific guidelines. A retrospective review was conducted of HF discharges from 19 hospitals using GWTG HF in Wisconsin and Michigan from 2011-2014. Readmission rates were determined from Centers for Medicare and Medicaid Services data. Results: 19 hospitals demonstrated improvement in the percentage of HF patients undergoing a follow-up visit within 7 days of hospital discharge when using GWTG HF as a QI program. As the percentage of HF patients receiving a follow-up visit within 7 days of hospital discharge increases, the number of readmissions decreases by 3% or 413 discharges over 4 years, which resulted in $5,369,000 cost savings. Conclusions: An in-hospital QI program, such as GWTG HF, improves the percentage of HF patients receiving a follow-up visit with 7 days of hospital discharge. Adherence to patient follow up visits for HF patients within 7 days of discharge leads to reduction in readmission rates. This translates into significant healthcare cost saving directly related to readmission in this patient category. Larger studies using a higher number of hospitals participating in quality programs is recommended.

scholarly journals Impact of Heart Failure Focused Follow-Up Care at the “Heart Success Clinic” on 30-Day Readmission Rates in Patients with Congestive Heart Failure

2020 ◽  
pp. 1-3
Author(s):  
Deepti Bhandare ◽  
Keyword(s):  
Heart Failure ◽  
Patient Outcomes ◽  
Readmission Rate ◽  
The United States ◽  
Hospital Data ◽  
Readmission Rates ◽  
Medication Reviews ◽  
Improve Patient

Nearly 6.2 million people in the United states are affected by heart failure, it is predicted that this number will rise to 8.5 million by 2030 Significant effort has been made to prevent heart failure and its exacerbations. The Hospital Readmission Reduction Program (HRRP), a Medicaare based program, was established to link payment to quality of care. Payment is reduced to hospitals when patients are readmitted within 30 days for heart failure The “Heart Success Clinic” is an outpatient clinic started to improve patient outcomes and reduce readmission rates. Patients are provided with heart failure focused visits which includes detailed medication reviews, diet modification, weight loss, disease education, etc. During the six months prior to the opening of the clinic, the readmission rate was 15.27% at AdventHealth Sebring hospital which is a community-based hospital. Data was collected on the patients who attended the “Heart Success Clinic” for six months. Zero patients from the clinic were readmitted, bringing the readmission rate down from 15.27% to 0%. This pilot study gives promising initial results. Further studies can be conducted over a longer period time as to gather more patients. Overall, the study demonstrates that there is value in providing heart failure focused follow up visits in improving patient outcomes and readmission rates.

scholarly journals Booking the Appointment: A Strategy to Reduce Readmissions in Heart Failure Patients

2013 ◽  
Author(s):  
Lindsey Moran
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Acute Care Hospital ◽  
The United States ◽  
Primary Diagnosis ◽  
Care Hospital ◽  
Chart Audit ◽  
Readmission Rates ◽  
June July

Heart failure (HF) is a chronic condition that is the cause for many hospitalizations in the United States. Hospital readmission is a common problem in many chronic conditions, especially heart failure. The purpose of this research was to determine if scheduling a follow-up appointment with a primary care provider (PCP) or cardiologist prior to hospital discharge decreases 30-day readmission rates in patients with a primary diagnosis of HF. A quasi-experimental, two-group study was performed at The Miriam Hospital, a 247-bed acute care hospital, with a sample of 60 patients. A retrospective chart audit was performed to determine if 30-day readmission rates were lower in those HF patients who had a follow-up appointment booked prior to hospital discharge than those who did not have the appointment booked. Charts were reviewed for patients discharged during June, July, August and September 2012. Basic descriptive statistics were performed as well as differences between groups. Thirty-day readmission rates were lower for those who had a follow-up appointment booked (22.58%) compared those who did not have an appointment booked (31.03%). The 30-day readmission rate for those who had an appointment with a PCP was higher than those who followed up with a cardiologist (33.33% versus 7.69%). These findings suggest that booking a follow-up appointment for HF patients with a cardiologist prior to hospital discharge may help to decrease 30-day readmission rates. This simple intervention can be performed by nonclinical, administrative staff and could save hospitals money if even one HF readmission were prevented.

scholarly journals Whole blood chromium concentration is very rarely elevated independently of whole blood cobalt

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olli Lainiala ◽  
Mari Karsikas ◽  
Aleksi Reito ◽  
Antti Eskelinen
Keyword(s):  
Whole Blood ◽  
Cost Savings ◽  
Chromium Concentration ◽  
Continuous Variables ◽  
Metal Debris ◽  
Screening Guidelines ◽  
Metal On Metal ◽  
Hip Replacements

AbstractDue to the risk of adverse reactions to metal debris resulting from increased wear of the arthroplasty more than one million metal-on-metal (MoM) hip replacements worldwide are in active follow-up. Follow-up usually includes measurement of both whole blood cobalt (Co) and chromium (Cr) concentrations. Our experience is that Cr is seldom independently elevated. We wanted to ascertain whether blood Cr measurements could be omitted from follow-up protocols without lowering the quality of follow-up. We identified 8438 whole blood Co and Cr measurements performed without or prior to revision surgery. When the cut-off levels 5 µg/L and 7 µg/L were used, Cr was independently elevated in only 0.5% (95% confidence interval, CI, 0.3 to 0.6) and 0.2% (CI 0.1 to 0.3) of the measurements. The models with continuous variables showed that the higher the blood metal concentrations are the lower the percentage of measurements with Cr higher than Co. Our results suggest that whole blood Cr is very rarely independently elevated and therefore the authorities should consider omitting Cr measurements from their screening guidelines of MoM hip replacements. We believe this change in practice would simplify follow-up and lead to cost savings without decreasing the quality of follow-up.

scholarly journals Trends in cause-specific readmissions in heart failure with preserved versus reduced and mid-range ejection fraction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X.T Cui ◽  
E Thunstrom ◽  
U Dahlstrom ◽  
J.M Zhou ◽  
J.B Ge ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Temporal Trend ◽  
Funding Source ◽  
Preserved Ejection Fraction ◽  
Readmission Rates ◽  
P Values ◽  
National Board ◽  
Over Time

Abstract Background It remains unclear whether the readmission of heart failure (HF) patients has decreased over time and how it differs among HF with preserved ejection fraction (EF) (HFpEF) versus reduced EF (HFrEF) and mid-range EF (HFmrEF). Methods We evaluated HF patients index hospitalized from January 2004 to December 2011 in the Swedish Heart Failure Registry with 1-year follow-up. Outcome measures were the first occurring all-cause, cardiovascular (CV) and HF readmissions. Results Totally 20,877 HF patients (11,064 HFrEF, 4,215 HFmrEF, 5,562 HFpEF) were included in the study. All-cause readmission was highest in patients with HFpEF, whereas CV and HF readmissions were highest in HFrEF. From 2004 to 2011, HF readmission rates within 6 months (from 22.3% to 17.3%, P=0.003) and 1 year (from 27.7% to 23.4%, P=0.019) in HFpEF declined, and the risk for 1-year HF readmission in HFpEF was reduced by 7% after adjusting for age and sex (P=0.022). Likewise, risk factors for HF readmission in HFpEF changed. However, no significant changes in cause-specific readmissions were observed in HFrEF. Time to the first readmission did not change significantly from 2004 to 2011, regardless of EF subgroup (all P-values>0.05). Conclusions Although the burden of all-cause readmission remained highest in HFpEF versus HFrEF and HFmrEF, a declining temporal trend in 6-month and 1-year HF readmission rates was found in patients with HFpEF, suggesting that non-HF-related readmission represents a big challenge for clinical practice. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The SwedeHF was funded by the Swedish National Board of Health and Welfare, the Swedish Association of Local Authorities and Regions.

scholarly journals Impact of Pharmacy Student–Driven Postdischarge Telephone Calls on Heart Failure Hospital Readmission Rates: A Pilot Program

2018 ◽  
Vol 54 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Roda Plakogiannis ◽  
Ana Mola ◽  
Shreya Sinha ◽  
Abraham Stefanidis ◽  
Hannah Oh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Discharge ◽  
Hospital Readmission ◽  
Pharmacy Students ◽  
Pharmacy Student ◽  
Pilot Program ◽  
Readmission Rates ◽  
Phone Calls ◽  
Hospital Readmission Rates ◽  
Telephone Calls

Background: Heart failure (HF) hospitalization rates have remained high in the past 10 years. Numerous studies have shown significant improvement in HF readmission rates when pharmacists or pharmacy residents conduct postdischarge telephone calls. Objective: The purpose of this retrospective review of a pilot program was to evaluate the impact of pharmacy student–driven postdischarge phone calls on 30- and 90-day hospital readmission rates in patients recently discharged with HF. Methods: A retrospective manual chart review was conducted for all patients who received a telephone call from the pharmacy students. The primary endpoint compared historical readmissions, 30 and 90 days prior to hospital discharge, with 30 and 90 days post discharge readmissions. For the secondary endpoints, historical and postdischarge 30-day and 90-day readmission rates were compared for patients with a primary diagnosis of HF and for patients with a secondary diagnosis of HF. Descriptive statistics were calculated in the form of means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Results: Statistically significant decrease was observed for both the 30-day ( P = .006) and 90-day ( P = .007) readmission periods. Prior to the pharmacy students’ phone calls, the overall group of 131 patients had historical readmission rates of 24.43% within 30 days and 38.17% within 90 days after hospital discharge. After the postdischarge phone calls, the readmission rates decreased to 11.45%, for 30 days, and 22.90%, for 90 days. Conclusion: Postdischarge phone calls, specifically made by pharmacy students, demonstrated a positive impact on reducing HF-associated hospital readmissions, adding to the growing body of evidence of different methods of pharmacy interventions and highlighting the clinical impact pharmacy students may have in transition of care services.

scholarly journals TEMPORAL TRENDS IN EARLY FOLLOW-UP AFTER HOSPITALIZATION FOR HEART FAILURE: DATA FROM GET WITH THE GUIDELINES-HEART FAILURE

2014 ◽  
Vol 63 (12) ◽  
pp. A745
Author(s):  
Adam DeVore ◽  
Margueritte Cox ◽  
Zubin Eapen ◽  
Clyde Yancy ◽  
Deepak Bhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Temporal Trends ◽  
Failure Data ◽  
Get With The Guidelines

scholarly journals Quality of life in patients with chronic heart failure and their carers: a 3-year follow-up study assessing hospitalization and mortality

2010 ◽  
Vol 12 (9) ◽  
pp. 1002-1008 ◽  
Author(s):  
Javaid Iqbal ◽  
Loraine Francis ◽  
Janet Reid ◽  
Scott Murray ◽  
Martin Denvir
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Follow Up Study
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