EFFECTIVENESS OF

COMPREHENSIVE DISCHARGE

PLANNING IN REDUCING

CONGESTIVE HEART FAILURE

READMISSIONS

GRETA ABERNATHY, RN

RN-BSN STUDENT

CONCORDIA COLLEGE ALABAMA

NO COI

• There are no companies, etc. in a relation of conflict of

interest requiring disclosure by the presenter(s) in

relation to the contents of the presentation.

OBJECTIVES

At the completion of this presentation, the participate

will:

1.To discuss the prevalence of elderly adults with

Congestive Heart Failure hospital readmissions.

2.To discuss effective EBP strategies that could

potentially reduce or break the readmission cycle.

PICOT QUESTION

• In elderly patients age 65 or older with Congestive

Heart Failure (P) How effective is the use of a

comprehensive discharge plan and medication

education (I) Compared to usual care (C) In reducing

readmissions for exacerbation of symptoms (O) Within

30 days of discharge (T)?

INTRODUCTION

• Heart failure happens when the heart

cannot pump enough blood and

oxygen to support other organs in

your body.

INTRODUCTION• The CDC has reported that there are 5.7 million

adults in the United States that have a diagnosis of

Congestive Heart Failure.

• The overall 30-day readmission rate after a

congestive heart failure hospitalization is 24.8

percent.

INTRODUCTION

• Sixty-one percent of congestive heart failure

readmissions occur within 15 days of discharge.

• Congestive heart failure diagnoses accounted for 55.9

percent for readmissions.

INTRODUCTION

• To encourage hospitals to reduce readmissions,

Congress created in the Affordable Care Act (ACA)

the Hospital Readmissions Reduction Program

(HRRP), and this allows CMS to penalize hospitals

with higher-than-expected 30 day readmissions.

INTRODUCTION

PROBLEM

• Congestive Heart Failure readmissions is the problem,

because the more readmissions the lower the patients

quality of life.

• A solution to the problem is the use of a comprehensive

discharge plan to prevent the readmissions.

REVIEW OF LITERATURE

• Implementation of heart failure readmission

reduction: A role for medical residents the purpose of

the study was to describe the integration of residents

into the implementation of a CHF readmission program.

REVIEW OF LITERATURE

• Hospital Strategies Associated with 30-day

Readmission Rates for Patients with Heart Failure,

the purpose of the study was to gain evidence of the

effectiveness of strategies that would help to lower

readmission rates.

REVIEW OF LITERATURE

• Evidence Based Strategies to Reduce Readmissions

in Patients with Heart Failure, the purpose of the

study was to find strategies that would reduce heart

failure readmissions that were cost efficient, and that

would improve the patient’s quality of life.

REVIEW OF LITERATURE

• Achieve Reduced Heart Failure Readmission Rates:

One Healthcare Organization’s Care Coordination,

the purpose of the study is to fix problems with care

coordination in the HF care management process within

this healthcare system, and provide a consistent plan

with all the clinics and hospitals.

REVIEW OF LITERATURE

• How to Reduce Heart Failure Readmission Rates:

One Hospital’s Story, the purpose of the study was to

improve the quality management to track patients with

CHF and are at greatest risk for readmission through

information technology.

REVIEW OF LITERATURE

• The effect of Heart Failure Education on Reducing

Admissions, the purpose of this study was to reduce

readmission rates by implementing educational

interventions in an outpatient setting post discharge.

INTERVENTIONS/MEASURES

• Follow up appointments with primary care and cardiologist.

• Provide primary care physician with a discharge summary.

• Educate the patient about the disease process and importance of the medication regemine.

• Provide the patient with a self-care plan.

• Refer to a HF clinic if one is available.

THE ULTIMATE GOAL

Q & A

BIBLIOGRAPHY• Rabbat, J., Bashari D. R., Khillan, R., Rai M., Villamil, J., Pearson, J. M., Saxena, A., (2012). Implementation of a heart failure readmission reduction program: A

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• Bradley, E. H., Curry, L., Horwitz, L. I., Sipsma, H., Wang, Yonfei., Walsh, M. N., Goldmann, D., White, N., Pina, I. L., Krumholz, H. M., (2013). Hospital

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• Kim, S. M., Han, H. R., (2013). Evidence-based strategies to reduce readmission in patients with heart failure. Journal for Nurse Practioners, Volume 9(4).

Retrieved from http://www.medscape.com/viewarticle/782534_3

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Improvement, Retrieved from https://www.healthcatalyst.com/success_stories/how-to-reduce-heart-failure-readmission-rates

• Kubo, S., (2016). How to reduce heart failure readmission rates: One hospital’s story. Health Catalyst Ignite Outcomes Improvement, Retrieved from

https://www.healthcatalyst.com/success_stories/how-to-reduce-heart-failure-readmission-rates

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