Critical Analysis Of Hospitals Strategies Associated With 30 Day Readmission Rate For Heart Failure Patients

Heart failure may convey that the heart isn’t working anymore, but what it really means is that the heart isn’t pumping as well as it should be (REF). Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body’s needs for blood and oxygen (REF). At first, the heart tries to make up for this by enlarging, developing more muscle mass, and pumping faster. As this happens, the blood vessels narrow to keep blood pressure up and the body diverts blood away from less important tissues and organs to maintain flow to the heart and brain (REF). Eventually, the body and heart cannot keep up and the patient begins to feel fatigue, breathing problems, weight gain with swelling in the feet, legs, ankles or stomach, and other symptoms that eventually leads to a hospital visit. The body’s coping mechanisms give us better understanding on why many are unaware of their condition until years after the heart declines (REF).

In the UK, reports show that heart failure has been affecting up to 2% of the population, over 900,000 people are living with heart failure, with 63,000 new cases being diagnosed each year (BHF, 2015). It costs the NHS £625 million per year, as a result of the high portion of emergency admissions, readmission and long length of inpatient stay (NHS Improvement, 2010). DH (2000) confirmed that Heart failure accounts for all cardiac admissions and the readmission rate can be as high as 50% within 3 months; also, it further estimated 50% readmission might be preventable. Unfortunately, Heart Failure can’t be cured, but early

Hospital readmissions are potentially harmful, costly and often times an avoidable event. Between the provisions set forth under the Affordable Care Act and the penalties authorized by the Centers of Medicare and Medicaid Services, hospitals are forced to shift their focus towards the development of strategies to reduce and prevent avoidable hospital readmissions related to heart failure. It is estimated that of the 6 million individuals within the United States diagnosed with heart failure, 1 million of them are hospitalized each year with a primary diagnosis of heart failure, accounting for $17 billion dollars of Medicare expenditures (Sales et al, 2013). What is worse is the death rate associated with heart failure each year, accounting

The Affordable Care Act was enacted to improve health care and to lower health care cost in America. The ACA developed different strategies to meet these goals called the “pay for performance” programs. These strategies are aimed at the different providers to improve quality care. The strategy that I selected is the “Hospital Readmissions Reduction Program” this program/strategy is also known as the HRRP and was begun in October of 2012. HRRP is aimed at hospitals and penalizes hospitals that have a high 30 day readmission rate. The penalties are assessed and based on a number of comparisons, those such as, performance, patient demographics, comorbidities and frailty.

In addition, it also measures the quality of care and patient satisfaction. In 2015, the US Secretary of HHS has announced a goal of 85 percentages of Medicare Fee for Service payments tied to quality or value. In addition, many new payment models are associated with HRRP; for instance, forthcoming Skilled Nursing Facility VBP program and Dialysis Adequacy measure , potentially specifies preventable readmission measures. As the system is moving from quantity to quality, it is beneficial to implement quality of standards to optimize future benefits for the community and Central Health as well. Currently, Central Health has higher readmission rate than national average with an overall rating of 2 out of 5. Penalties incurred due to below standard of care could strain hospital resources to utilize for the betterment of our facility. Furthermore, the incentive structure has concerned Central Health to reevaluate the mode of practice and care provided engaging healthcare providers and patients. Central Health is committed to reducing readmission rates by identifying and sharing best practices for long term benefits. Given the flexibility of penalty under the 21st Cure Act, the initial program will focus on readmission prevention within 30 days of hospital

Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the

In 2001, the US Institute of Medicine’s seminal report, ‘Crossing the Quality Chasm: A New Health System for the 21st Century’, recommended six goals for improvement in healthcare, with one focusing on patient-centred care (Institute of Medicine [IOM], 2011). Furthermore, various international organisations, such as the Institute for Patient- and Family-

Quality patient centered care is vital to a hospital or clinic’s ability to treat whole patients. Dabney and Tzeng (2013) address the necessity to implement patient-centered care into clinic and hospital settings. The article clarifies what patient-centered care and service quality is by consolidating many works and sighting benefits medical professionals can observe in their practice.

Quality of care is the fundamental goal of health care, yet it is difficult to define. It is a concept that health care policy and programming strives for, and that many have attempted to elucidate. Given its many components and manifestations, defining and quantifying

The Pennsylvania researchers collected data from 200,000 nurses, and from 412 different hospitals in Pennsylvania, New Jersey and California. The research concluded that readmission less than 30 days of Medicare patients older than 65 years with acute myocardial infarction, pneumonia and heart failure, had a 10% lower rate of readmission. The good outcome was as a result of better nurse working environment and controllable patient workloads for

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

A great amount of time, money and resource is devoted to improving the transition to home from hospital in the heart failure patient (Qaddoura, Ashoori, Kabali, Thabane, Haynes, Connolly & Spall, 2015). With extensive research available on heart failure and readmission, this study will focus on four main categories. This four category approach allows the clinician to best formulate and prepare for practice in the outpatient setting. The four categories will include various articles based upon evidenced based practice approaches with ultimate goal of reducing admission by implementing successful outpatient care. The four categories are as follows: Frequent monitoring or reporting to the PCP; Medication and Diet compliance; Predictors of

This article explores how the ideology of patients centered care came to be, and how it should ideally look in practice.

In recent years, the concept of patient-centered care has become a goal in itself and a tool for enhancing health outcomes for patients. If patient-centered care is properly implemented, it can have a huge impact in the health care profession. Due to the increased attention on improving the health care system, patient-centered care is an essential aspiration of high-quality health care systems. The physician-patient relationship remains an integral part of the healthcare system but there are other aspects that affect patient-centered care. According to Greene, Tuzzio, and Cherkin, patient-centered care “honors the patient’s preferences, needs, and values; applies a biopsychosocial perspective rather than a purely biomedical

Koelling, Johnson, Cody, & Aaronson (2005) performed a study to discern if a discharge education program would improve clinical outcomes in patients with chronic heart failure. The study used a randomized, controlled trail of systolic heart failure patients. The effect of a 1-hour, one-on-one teaching session with a nurse educator was compared with the standard discharge process. The number of days hospitalized or dead in the 180-day follow up period was significantly lower for the education group (1554 days) than for the control group (2103 days). The combined end point of death or rehospitalization occurred in 64% of control and 47% of education patients, with the time of first hospitalization or death significantly lower for the education group. The combined end point of rehospitalization or death was reduced in the patients exposed to the education intervention by 35% compared to the controls. For this group there was also a 51% reduction in the need to be rehospitalized due to heart failure. The program was also effective in reducing costs per patient. The reduction in rehospitalizations in the education group led to saving $2823 per