JACC. Case reports · 2025
Reducing Readmissions After Transcatheter Aortic Valve Replacement Through Enhanced Transitional Care.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Theriot Misty L, Bergen Edward C, Lugo Joseph G, Fuselier Janie E
Аннотация
BACKGROUND: Transcatheter aortic valve replacement (TAVR) volumes continue to expand, increasing the need for optimized periprocedural and transitional care. Readmissions have substantial clinical and financial impact.
PROJECT RATIONALE: In 2018-2019, Lake Charles Memorial Hospital's 30-day post-TAVR readmission rate was 12.7%, with 58% unrelated to valve complications, prompting a quality-improvement initiative.
PROJECT SUMMARY: A phased, multidisciplinary pathway incorporated standardized discharge education, early follow-up, conduction system disease monitoring, social determinants of health screening with tailored resources provided, and home monitoring for high-risk patients. Guided by Plan-Do-Study-Act cycles, interventions emphasized patient engagement, proactive complication detection, and continuity of care. Post implementation (2022-2025 Q2), readmissions declined to 1.9% despite a higher-risk cohort, with concurrent reductions in length of stay and substantial cost savings.
TAKE-HOME MESSAGES: Structured, multidisciplinary transitional care can markedly reduce post-TAVR readmissions. Long-term sustainability is supported through patient-centered strategies and integration of social determinants of health-focused interventions.
PROJECT RATIONALE: In 2018-2019, Lake Charles Memorial Hospital's 30-day post-TAVR readmission rate was 12.7%, with 58% unrelated to valve complications, prompting a quality-improvement initiative.
PROJECT SUMMARY: A phased, multidisciplinary pathway incorporated standardized discharge education, early follow-up, conduction system disease monitoring, social determinants of health screening with tailored resources provided, and home monitoring for high-risk patients. Guided by Plan-Do-Study-Act cycles, interventions emphasized patient engagement, proactive complication detection, and continuity of care. Post implementation (2022-2025 Q2), readmissions declined to 1.9% despite a higher-risk cohort, with concurrent reductions in length of stay and substantial cost savings.
TAKE-HOME MESSAGES: Structured, multidisciplinary transitional care can markedly reduce post-TAVR readmissions. Long-term sustainability is supported through patient-centered strategies and integration of social determinants of health-focused interventions.