Congestive heart failure (CHF) is the leading hospital admission diagnosis for patients over 65. It carries with it a significant toll on the quality of life and mortality of the patients diagnosed with it. There is a tremendous economic burden on the health care system as well, with an estimated $34.8 billion dollars in direct and indirect costs annually. Frequent hospital readmissions play a significant role in these costs. A multidisciplinary team at Abbott Northwestern (ANW) Hospital in Minneapolis has identified 4 high‐impact interventions and has reduced the number of rehospitalizations for patients with a principal diagnosis of CHF within 30 days of discharge by nearly 30%.
To decrease the 30‐day hospital readmission rate for patients with CHF by implementing 4 high‐level interventions aimed at improving the transition between hospital and home.
The ANW Heart Failure Workgroup identified 4 high‐impact interventions to decrease CHF readmissions within 30 days, mainly focusing on the transition between hospital and home. The interventions are: (1) establish a 3‐ to 5‐day follow‐up for all CHF patients; (2) ensure medication reconciliation (the discharge medications match between the discharge orders, discharge summary, and the patients discharge medication list); (3) improve the flow and quality of information from the hospital to the primary care clinic; and (4) improve education and self‐management tools for patients with CHF. These interventions were implemented in 2007 and early 2008 across the Allina system (10 hospitals, more than 40 clinic sites). Patients with a principal diagnosis of CHF on admission were tracked for readmission within 30 days after discharge. Patients with hospital readmissions for any diagnosis (except elective admissions) were counted toward the readmission rate. In 2006, the readmission rate at ANW hospital was 21.1% (829 CHF discharges and 175 readmits). In 2007, the readmission rate was 21.6% (731 CHF discharges and 158 readmits). In 2008, the readmission rate was 17.9% (627 CHF discharges and 112 readmits through October 2008), a reduction of 16% (P = 0.067, ARR 3.5%, 95% Cl −0.3%–7.1%). Since March 2008, the readmission rate has decreased further to 15.5%, a 28.9% decrease (ARR 6.3%), although it remains to be seen if this trend will continue.
The effective implementation of the above interventions aimed at improving the transition process from hospital to home can show significant decreases in the 30‐day readmission rate for patients with CHF.
J. Kirven, none; S. Bergeson, none.
To cite this abstract:Kirven J, Bergeson S. Breaking the Cycle: Reducing Readmissions for Patients with Congestive Heart Failure. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 118. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/breaking-the-cycle-reducing-readmissions-for-patients-with-congestive-heart-failure/. Accessed September 16, 2019.