Hospital Re Admissions : Congestive Heart Failure

"Reducing 30-Day Readmissions for African Americans with Congestive Heart Failure by improving health literacy through a Comprehensive Context Oriented Discharge Plan”

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

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

Congestive heart failure is a growing chronic condition in the United States that accounts for over one million hospitalizations and is responsible for 27% of patients with heart failure on Medicare are readmitted with 30 days of discharge (Hines, Yu & Randall, 2010). The intensity of the disease process poses a financial strain on both the patient and the payers, especially Medicare, as 10 per 1000 population are 65 years or older and therefore a Medicare beneficiary (Mozaffarian et al., 2015). Consequently, in order to gain control over this chronic disease and its cost burden, the government and policy makers have shifted the responsibility to the health care facilities through the creation of policies that affect hospital reimbursement based on readmission rates. As a member of the quality team at my facility, the Hospital Readmissions Reduction Program deeply impacts my practice and encourages the hospital as a whole to focus on improving multidisciplinary collaboration in pursuit of quality patient care, resulting in better outcomes and decreased readmissions.

This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many

Each year the number of readmissions of the heart failure patient within 30 days of discharge has grown. The Medicare division in relation with the Affordable Care Act is reducing the amount of money they are willing to pay for readmissions to the hospital. Hospitals are now more than ever looking for ways to reduce the number of readmissions to the hospital for the heart failure patient. The purpose of this paper is take a look at a program designed with to reduce the readmission rates of one hospital to reduce the number of readmission through improved education and follow up of the heart failure patient.

Congestive Heart Failure (CHF) patients and their consistent trending of hospital re-admissions continue to threaten quality care and patient quality of life. Considered a chronic condition, CHF is diagnosed in approximately 13% of patients 85 or older (Clarke, Shah & Sharma, 2011). Re-admissions have become so prevalent among the CHF populations, that Centers for Medicare has initiated a quality campaign and offers incentives when hospitals implement telemedicine programs and show reduction in CHF hospital admissions. In relation to CHF, Conway, Inglis, and Clark (2014) states that, “Telemedicine involves transmission of physiological data, such as weight, … from the measuring device to a central server via telephonic, satellite,

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

Policy makers are constantly searching for new innovative ways to increase quality patient care and lower Medicare program spending. One indicator of inadequate quality that results in increased Medicare spending is the rate of readmissions to the hospital. Heart Failure patients are on the top of that list. Readmission refers to a patient’s being hospitalized within 30 days of an initial hosptial stay. This seems to be an indicator of inadequate quality of care in the hospital or a lack of appropriate coordination of postdischarge care.

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

Rising health care cost and stricter regulations for insurance reimbursement plans have pushed health care leaders to re-evaluate health care services. One focus is reducing hospital readmission rates for chronic disease process (Bos-Touwen et al, 2015). Congestive heart failure is one of the leading causes of hospital readmission (Cubbon et al, 2014). Fifteen million people worldwide have a diagnosis of CHF. In addition, 15-20% of those with the diagnosis of CHF are hospitalized yearly (Sahebi et al, 2015). In 2010, 40 billion dollars was spent on health care needs for CHF patients. Seventy percent of the resources were for hospital services (Siabani, Driscoll, Davidson, and Leeder, 2014). The need for streamline healthcare for CHF patients is imperative to improve overall patient outcomes and reduce the amount of hospital readmission rates.

As one of the most frequent hospital discharge diagnosis in the elderly, the cost of heart failure on Medicare expenditures toped over $39 billion in 2010 (Warden, Freels, Furuno, & Mackay, 2014). For over 25 years, there have been studies looking at the number of readmissions of geriatric heart failure

Congestive heart failure (CHF) readmissions are associated with financial penalties for organizations. You chose such a vital problem for acute care facilities. Unfortunately, few interventions have been identified that effectively decrease hospital readmission rates. One intervention the hospital I work for recently implemented is an Interprofessional approach. Physicians, nurses and the pharmacy department collaborated to improve our discharge process with primary diagnosis CHF. We now have a pharmacist counsel the patient prior to discharge on their medications. I do not have empirical data to provide, however, I think this has helped our patients somewhat. Another strategy our cardiologists are promoting with our hospitalist

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

Congestive heart failure (CHF) is the leading cause of hospitalization among patients older than 65 year of age. Annually, greater than 1 million patients are hospitalized with a primary diagnosis of heart failure, accounting for a total Medicare expenditure exceeding $17 billion (Desai & Stevenson, 2012). Heart failure (HF) occurs when cardiac output is insufficient to provide adequate blood flow to meet metabolic and circulatory demands (Houston, Kalathiya, Kim, & Zakaria, 2015). Despite dramatic improvement in outcomes with medical therapy, admission rates following heart failure hospitalization remain high, with greater than or equal 50% patients readmitted to hospital within 6 months of discharge (Desai & Stevenson, 2012). Mortality in Heart Failure is high, approaching 20% at 1 year and 50% at 4 years (Rickenbacher et al., 2012). The purpose of this paper is to evaluate how the application of Roy’s theory of adaptation model can decrease hospital readmissions and mortality in patients with heart failure. The Roy adaptation model (RAM) is an appropriate guide when providing nursing practice care for patients with chronic diseases such as heart failure (Bakan & Akyol, 2007). The use of Roy’s theory can show interventions of how patients can adapt to their condition and how it can decrease hospital readmission and mortality in patients with heart failure. Therefore, the content of this paper will examine the application of RAM applied to heart failure patients.