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Protocol-Driven Allied Health Post-Discharge Transition Clinic to Reduce Hospital Readmissions in Heart Failure.
Donaho, Erin K; Hall, Andrea C; Gass, Jennifer A; Elayda, Macarthur A; Lee, Vei-Vei; Paire, Shreda; Meyers, Deborah E.
Afiliación
  • Donaho EK; Seasons Hospice Care, Houston, TX (E.K.D.).
  • Hall AC; Pharmacy Department, Memorial Hermann TMC, Houston, TX (A.C.H., J.A.G.).
  • Gass JA; Pharmacy Department, Memorial Hermann TMC, Houston, TX (A.C.H., J.A.G.).
  • Elayda MA; Texas Heart Institute, Houston, TX (M.A.E., V.V.L., D.E.M.).
  • Lee VV; Texas Heart Institute, Houston, TX (M.A.E., V.V.L., D.E.M.).
  • Paire S; Palliative Care Department, Kelsey Seybold Clinic, Houston, TX (S.P.).
  • Meyers DE; Texas Heart Institute, Houston, TX (M.A.E., V.V.L., D.E.M.).
J Am Heart Assoc ; 4(12)2015 Dec 23.
Article en En | MEDLINE | ID: mdl-26702083
BACKGROUND: Heart failure (HF) patients have high rates of hospitalization and rehospitalization. METHODS AND RESULTS: A protocol-driven clinic staffed by an allied health care team was designed for patients discharged from the hospital with a diagnosis of congestive HF. The clinic provided follow-up visits 1 week and 4 to 6 weeks after hospital discharge. One-hundred and fourteen patients were observed at least 1 time, and 80% of these patients completed the 2-visit protocol. Clinical evaluations were provided by a nurse practitioner specializing in HF and a clinical pharmacist; these evaluations included physical examination, laboratory evaluation, medical education and reconciliation, medication adjustment and titration, and care coordination. Referrals to home health and appropriate services were provided. At visit 1, 25% of patients were hypervolemic and 13% were hypovolemic. At visit 2, 20% were hypervolemic and 13% were hypovolemic. Medicine reconciliation errors were common, with an average of 2.1 and 0.8 errors per person recorded for visits 1 and 2, respectively. Clinic participants showed a 44.3% reduction in 30-day readmission rates, as compared to the hospital's average 30-day readmission rates. CONCLUSIONS: Protocol-driven postdischarge transition care delivered by allied health staff addressed multiple transition issues and was associated with a dramatic reduction in readmission rates.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Readmisión del Paciente / Insuficiencia Cardíaca Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2015 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Readmisión del Paciente / Insuficiencia Cardíaca Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Heart Assoc Año: 2015 Tipo del documento: Article Pais de publicación: Reino Unido