Medical College of Wisconsin
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National survey of hospital strategies to reduce heart failure readmissions: findings from the Get With the Guidelines-Heart Failure registry. Circ Heart Fail 2012 Nov;5(6):680-7 PMID: 22933525

Pubmed ID

22933525

DOI

10.1161/CIRCHEARTFAILURE.112.967406

Abstract

BACKGROUND: Reducing 30-day heart failure readmission rates is a national priority. Yet, little is known about how hospitals address the problem and whether hospital-based processes of care are associated with reductions in readmission rates.

METHODS AND RESULTS: We surveyed 100 randomly selected hospitals participating in the Get With the Guidelines-Heart Failure quality improvement program regarding common processes of care aimed at reducing readmissions. We grouped processes into 3 domains (ie, inpatient care, discharge and transitional care, and general quality improvement) and scored hospitals on the basis of survey responses using processes selected a priori. We used linear regression to examine associations between these domain scores and 30-day risk-standardized readmission rates. Of the 100 participating sites, 28% were academic centers and 64% were community hospitals. The median readmission rate among participating sites (24.0%; 95% CI, 22.6%-25.7%) was comparable with the national average (24.6%; 23.5-25.9). Sites varied substantially in care processes used for inpatient care, education, discharge process, care transitions, and quality improvement. Overall, neither inpatient care nor general quality improvement domains were associated with 30-day readmission rates. Hospitals in the lowest readmission rate quartile had modestly higher discharge and transitional care domain scores (P=0.03).

CONCLUSIONS: A variety of strategies are used by hospitals in an attempt to improve 30-day readmission rates for patients hospitalized with heart failure. Although more complete discharge and transitional care processes may be modestly associated with lower 30-day readmission rates, most current strategies are not associated with lower readmission rates.

Author List

Kociol RD, Peterson ED, Hammill BG, Flynn KE, Heidenreich PA, PiƱa IL, Lytle BL, Albert NM, Curtis LH, Fonarow GC, Hernandez AF

Author

Kathryn Eve Flynn PhD Associate Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84873383996   70 Citations

MESH terms used to index this publication - Major topics in bold

Continuity of Patient Care
Data Collection
Guidelines as Topic
Heart Failure
Humans
Linear Models
Patient Readmission
Quality Improvement
Quality of Health Care
Registries
Risk Reduction Behavior
United States
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e