Multidisciplinary rounds in prevention of 30-day readmissions and decreasing length of stay in heart failure patients: A community hospital based retrospective study.


Journal

Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R

Informations de publication

Date de publication:
Jul 2019
Historique:
entrez: 7 7 2019
pubmed: 7 7 2019
medline: 12 7 2019
Statut: ppublish

Résumé

To assess the impact of multidisciplinary rounds (MDR) on 30-day readmissions and length of stay in hospitalized patients with a diagnosis of congestive heart failure in a community teaching hospital.Patients with primary admission diagnosis of congestive heart failure (CHF) were included. A before and after retrospective study was conducted once the intervention was implemented in 2014. The before and after study periods were each of 1-year duration and included 181 and 151 patients, respectively. Our multidisciplinary heart failure rounding team consisted of a staff cardiologist, case manager, pharmacist, social worker, and a nutritionist.The mean length of stay decreased from 5.7 days to 5 days, and 30-day readmissions decreased from 27.6% to 17.22% (P-value .026) after implementation of the multidisciplinary rounding. We observed a significant decrease of readmissions in ischemic cardiomyopathy (ICM) (from 33.61% to 14.01%; P-value .007) and heart failure with reduced ejection fraction (HFrEF) (from 31.34% to 16.05%; P-value .028) patients. There was an increase in the percentage of patients hospitalized with non-ischemic cardiomyopathy (NICM) and heart failure with preserved ejection fraction (HFpEF) and, in particular, women patients with heart failure.Implementation of MDR program on CHF patients resulted in significant decrease in both readmission rate and length of stay in our hospital.

Identifiants

pubmed: 31277137
doi: 10.1097/MD.0000000000016233
pii: 00005792-201907050-00052
pmc: PMC6635156
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e16233

Références

JAMA. 2011 Oct 26;306(16):1794-5
pubmed: 22028355
Prog Cardiovasc Dis. 2017 Sep - Oct;60(2):187-197
pubmed: 28847619
Am J Med Qual. 2014 May-Jun;29(3):220-6
pubmed: 23956341
JAMA. 2004 Mar 17;291(11):1358-67
pubmed: 15026403
Am Heart J. 1997 Jun;133(6):703-12
pubmed: 9200399
Circulation. 2015 Jan 27;131(4):e29-322
pubmed: 25520374
BMJ. 2013 Dec 16;347:f7171
pubmed: 24342737
J Am Coll Cardiol. 2009 Apr 14;53(15):e1-e90
pubmed: 19358937
N Engl J Med. 1995 Nov 2;333(18):1190-5
pubmed: 7565975
Congest Heart Fail. 2013 Jul-Aug;19(4):200-6
pubmed: 23910702
Circ Heart Fail. 2012 Nov;5(6):680-7
pubmed: 22933525
Patient Educ Couns. 2018 Mar;101(3):363-374
pubmed: 29102442

Auteurs

Raghuram Chava (R)

Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Nabin Karki (N)

Medstar Harbor Hospital, Baltimore, Maryland.

Kerunne Ketlogetswe (K)

Medstar Harbor Hospital, Baltimore, Maryland.

Tomas Ayala (T)

Medstar Harbor Hospital, Baltimore, Maryland.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH