Effectiveness of Comprehensive Discharge Planning in ... · effectiveness of comprehensive...
Transcript of Effectiveness of Comprehensive Discharge Planning in ... · effectiveness of comprehensive...
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.
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.
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
role for medical residents. Journal of Community Hospital Internal Medicine Perspectives, Volume 2(1). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714088/
• 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
strategies associated with 30-Day readmission rates for patients with heart failure. Circulation: Cardiovascular Quality and Outcomes, Volume 6(4).
Retrieved from http://circoutcomes.ahajournals.org/content/6/4/444?sid=57b82bed-a8cf-454c-a2af fe6760a7a96a#abstract-1
• 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
• Kubo, S., (2016). Achieve reduced heart failure readmission rates: One healthcare organization’s care coordination strategy. Health Catalyst Ignite Outcomes
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
• Villarruel, M. L., (2013). The effect of heart failure education on reducing readmissions. Evidence Based Practice Project Reports: Valpor Scholar, Retrieved
from http://scholar.valpo.edu/ebpr/49/