BMJ open quality · 2025
Multidisciplinary initiative to reduce 30-day readmissions in heart failure: a quality improvement perspective.
СтатьяНазвание и аннотация: Перевод в очереди
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Varghese Sharin Koshy, Francis Tina, Shah Jassim Zaheen, Gupta Poonam, Velusamy Elavarasi, Varghese Blessy Susan, Selvaraj Sathiya Priya, Renyn Lija Koshy, Savarimuthu Indirani, Mahinay Menandro, Al-Amri Maha Kassim, Azeem Arnoos Afnan Abdul, Thangaraj Parthasarathi, Natarajan Sasikala, Hamed Badr Amr Mohamed, Patel Ashfaq
Аннотация
AIM: Hospitalisation for heart failure (HF) carries a high risk of readmission and adverse patient outcomes. We noticed a higher rate of readmissions for HF patients in a tertiary cardiac centre in Doha, Qatar. This study is focused on using a multidisciplinary and quality improvement approach to reduce the HF patients' 30-day readmission rate to the high dependency unit C in Heart Hospital, Doha, Qatar, by 10% by December 2020 and 20% by December 2021.
METHODS: In collaboration with the Institute for Healthcare Improvement, we worked on this initiative as a multidisciplinary team and tested several changes. A model for improvement framework was used and rapid, weekly, plan-do-study-act cycles were applied to test changes. Multiple measures were implemented serially, which included follow-up telephone consultations by a HF clinical nurse specialist 1 week after hospital discharge, early follow-up in a dedicated HF clinic (within 2 weeks of discharge), the availability of medical guidance over the telephone, comprehensive health coaching and education, patient functional activity engagement and cardiac depression screenings.
RESULTS: The readmission rate reduced from 25.5% in 2019 to 5.6% in 2021 (p<0.001). The results achieved have been sustained over time, with readmission rates recorded at 7.87% to date. The study demonstrated a decrease in 30-day readmission rates for HF patients after implementing a multidisciplinary quality improvement initiative.
CONCLUSIONS: Reducing readmission rates underscores the importance of comprehensive patient education, tailored care plans, consistent follow-up and integrated team-based care in managing HF patients. The success of this initiative highlights the potential of multidisciplinary strategies in improving patient outcomes in chronic conditions like HF.
METHODS: In collaboration with the Institute for Healthcare Improvement, we worked on this initiative as a multidisciplinary team and tested several changes. A model for improvement framework was used and rapid, weekly, plan-do-study-act cycles were applied to test changes. Multiple measures were implemented serially, which included follow-up telephone consultations by a HF clinical nurse specialist 1 week after hospital discharge, early follow-up in a dedicated HF clinic (within 2 weeks of discharge), the availability of medical guidance over the telephone, comprehensive health coaching and education, patient functional activity engagement and cardiac depression screenings.
RESULTS: The readmission rate reduced from 25.5% in 2019 to 5.6% in 2021 (p<0.001). The results achieved have been sustained over time, with readmission rates recorded at 7.87% to date. The study demonstrated a decrease in 30-day readmission rates for HF patients after implementing a multidisciplinary quality improvement initiative.
CONCLUSIONS: Reducing readmission rates underscores the importance of comprehensive patient education, tailored care plans, consistent follow-up and integrated team-based care in managing HF patients. The success of this initiative highlights the potential of multidisciplinary strategies in improving patient outcomes in chronic conditions like HF.