How To Reduce Congestive Heart Failure

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

This study used a descriptive, correlational, comparative and quantitative design to determine the probable causes of heart failure readmissions (Anderson, 2014). Independent t tests were used to the characteristics between those individuals that were readmitted and those that were not. Correlation coefficients were examined using the Pearson product-moment and the Spearman ρ test to determine the indications for readmission. (Anderson, 2014). Once these were established the Hosmer and Lemeshow tests were used in binary logistical regression analysis to determine how well each predictor variable determined the probability of readmission. Using these tests, the results showed that P=0.599, indicating that the model adequately fits the data (Anderson, 2014). To add to this, further proving the study’s validity, a hierarchical approach was preferred because “entry of variables is based upon an evaluation of theoretic, clinical, and statistical considerations” (Anderson, 2014, p. 234). This allowed for the assessment of predictive ability. This study through multiple statistical tests proved strong validity in its data collection, research design, and measurement

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.

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,

With the law, hospitals have the opportunity to receive increased Medicare payments as long as they increase patient education about care after hospital discharge, provide patients with community healthcare resources, and increase discharge instructions for patients suffering from heart failure (Burton, 2012). The Centers for Medicare and Medicaid Services (CMS) has threatened to reduce hospital payments to one percent if the patient readmission rates of “heart failure, pneumonia, and myocardial infarction” increase past a certain limit (Burton, 2012). State Medicaid agencies will grant providers reimbursement if “comprehensive transitional care” is provided to patients (Burton, 2012). The law also offered $200 million towards projects aimed at increasing the number of advanced practicing nurses in areas including: chronic care, preventive care and primary care (Burton, 2012). Preventive care will allow nurses to reduce the rates of high acuity patients in their hospitals. If the PPACA fails to improve care transitions, the CMS plans to carry out other policies. These policies

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

As we care for our patients in a hospital settings, our goal is to get them better so that they can be discharged. Most of the time recovery continues at home or at another facility. With shorter stays in the hospital setting, the recovery at home requires increased nursing and caregiver interventions. Based on statistics published by the Center for Medicare and Medicaid Services (CMS), the rate for readmission, within the first 30 days of discharge, in 2012, for Medicare FFS (Fee-for-service) beneficiaries, averaged 18.4 percent (Gerhardt et al., 2013). Throughout this paper, readmission refers to a “return hospitalization to an acute hospital following a prior acute admission within

In my current role a President of our integrated care network, one are largest cost outliers in our Medicare cost report was our 30 day readmission rate. The government has defined 30 days as the time period they feel a patient should be not readmitted to a hospital for certain diagnoses. Studies have looked at the groups that have had intervention in terms of discharge planning, and those with no intervention or discharged in a "usual" fashion from an institution. A study in the journal Circulation in 2013 looked at this exact question and found that following certain protocols could reduce the readmission rates in heart failure patients (Bradley, et al., 2013).

With heart failure, increasing in incidence in the United States, hospital readmission rates are being scrutinized to save money, especially for Medicare beneficiaries. Over 5 million people in the United States are living with heart failure, defined as “a condition in which the heart cannot pump enough blood and oxygen to support other organs in the body” (CDC, 2013). Heart failure affects 2.4% of the United States population with nearly 12% of both women and men 80 years and older having heart failure (Heidenreich, P. A., Albert, N. M., Allen, L. C., Bluemke, D. A., Butler, J., Morrow, G. C., Ikonomidis, J. S., et al., 2013). Heidenreich et al (2013) project that by 2030, heart failure will affect over 8 million Americans, with 2 million of those being ages 80 years and older. Heart failure is one of three conditions to be included in the Centers for Medicare and Medicaid Services (CMS) reimbursements that hospitals are penalized for if the hospital experiences an excess amount of readmissions within 30 days of the initial hospitalization due to the disease.

The authors of this article explore the importance of and latest advances in transitions of care programs for patients with Heart Failure (HF). The authors paint a clear picture about the scope of the problem and go on to discuss some of the most well-known and researched transitions of care interventions in current practice. Although many of these interventions have been successful, the authors report fact that programs vary in organizational framework, team composition, and program focus. Programs are also noted to differ based on population size and care

Compliance takes priority. Julie devised and maintains the emergency room physician log which lists the supervising physician for each day. The thorough charting and initial treatment plans exceed the requirements set by CMS. Physician chart reviews and reports are completed in a timely fashion. She researched the specific criteria for the newly determined coverage requirements for patients with congestive heart failure (CHF) whereby she initiated an easy-to- follow document for physicians to utilize for coverage criteria when a patient has a diagnosis of CHF. She seamlessly transitioned her program’s referrals from the ICD 9 codes to the ICD 10 diagnosis codes for pulmonary and cardiac rehabilitation this past year. In addition, she has the responsibility of tailoring all of the corporate policies and procedures to meet the needs of the program at Fannin Regional Hospital, as well as reviewing and revising these fifty-four policies annually.

Patient education is essential to compliance and follow up for chronic disease. Peter et al. (2015) published results of their pilot quality improvement study. The population studied was patients readmitted with heart failure and was conducted during a 1 year period beginning July 2010 during which time 469 patients received heart failure discharge with 180 of them receiving education using the Teach-Back method. Needs assessment on readmissions with heart failure showed that patients did not understand previous discharge education either due to literacy or failure to get clarification on educational needs which was thought to impact readmission. The Teach-Back models incorporates patient and family in setting realistic goals and ensuring patient and family have clear understanding of diagnosis, medications, follow-up appointments

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

hospital in Ohio is currently looking at a program to help educate their heart failure patients, and to establish measures to ensure that the patient is following up after discharge. This paper will give the finding of the literature research and share a plan to improve the education for the heart failure patient.