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
Author(s):  
Robert Leone ◽  
Charles Walker ◽  
Linda Curry ◽  
Elizabeth Agee

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.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Robby Singh ◽  
Leon Varjabedian ◽  
Georgy Kaspar ◽  
Marcel Zughaib

Introduction. Congestive heart failure is a leading cause of cardiovascular morbidity and mortality that results in a significant financial burden on healthcare expenditure. Though various strategies have been employed to reduce hospital readmissions, one valuable tool that remains greatly underutilized is the CardioMEMS (Abbott), a remote pulmonary artery pressure-monitoring system, which has been shown to help reduce heart failure rehospitalizations in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial. Methods. ICD-9/ICD-10 codes for chronic heart failure were used to identify patients who presented with congestive heart failure. Of this group, those eligible for CardioMEMS device placement, as based on the CHAMPION trial definition, were selected. Subsequently, a retrospective review of the electronic medical records was completed. All patients were on ACC/AHA guideline-directed medical therapy and had at least one hospital admission for NYHA class III symptoms. Results. 473 patients met the inclusion criteria, of which, 85 patients were found to be eligible for implantation of CardioMEMS device based on the CHAMPION trial definition. Only 18/85 patients received the device, roughly 21%, and the overall CardioMEMS implantation rate was only 4% (18/473) of the total cohort. Conclusion. Despite the benefits to patients and reducing healthcare expenditure, there has been a poor adaptation of this groundbreaking technology. Our study revealed that 79% of eligible heart failure patients did not receive the device. Therefore, efforts need to be undertaken to improve physician and patient education of the device to complement the current standard of care for congestive heart failure.


2006 ◽  
Vol 12 (6) ◽  
pp. S110
Author(s):  
Lin Guo ◽  
Eugene S. Chung ◽  
Richard Snow ◽  
Kim L. Miller ◽  
Stephen Grossbart ◽  
...  

1999 ◽  
Vol 5 (3) ◽  
pp. 74 ◽  
Author(s):  
Lorraine S. Evangelista ◽  
Lynn V. Docring ◽  
Kathleen Dracup ◽  
Mary A. Woo

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Hao Wang ◽  
Richard D Robinson ◽  
Carlos Johnson ◽  
Nestor R Zenarosa ◽  
Rani D Jayswal ◽  
...  

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 150 ◽  
Author(s):  
Van Do ◽  
Lufei Young ◽  
Sue Barnason ◽  
Hoang Tran

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate heart failure knowledge (p=.005), low self-efficacy (p<.001) and low engagement in heart failure self-management behaviors (p<.001) after discharge from hospital.


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