Preventability of 30-Day Readmissions for Heart Failure Patients Before and After a Quality Improvement Initiative

Ryan, Jason; Andrews, Rebecca; Barry, Mary Beth; Kang, Sang‐Wook; Iskandar, Aline; Mehla, Priti; Ganeshan, Raj

doi:10.1177/1062860613496135

Cited by 10 publications

(28 citation statements)

References 28 publications

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“…This allowed use of their different backgrounds in choosing which elements of the clinical record to focus on. ’ [33]…”

Section: Resultsmentioning

confidence: 99%

“…Several studies used an existing tool, like the STate Action on Avoidable Rehospitalizations (STAAR) initiative [14, 21, 27, 30, 34] or root cause approach [5, 18, 24, 35–37] but all others adapted an existing tool or developed their own tool based on previous publications. For the purpose of this article we focused only on the distinction between studies using an a priori preventability cause classification [13–16, 19, 21–26, 31, 35, 37–55], or not [5, 17, 18, 20, 27–30, 32, 33, 36, 56–59], see Table 2 . As an example of an a priori cause classification, Clarke et al reported, Unavoidable causes: chronic or relapsing disorder; unavoidable complication, readmission for social or psychological reason, reasons probably beyond control of hospital services, completely different diagnosis from previous admission.…”

Section: Resultsmentioning

confidence: 99%

“…The reviewers were most often physicians (specialists) or a combination hereof [5, 13, 15–18, 20–23, 25, 27, 28, 30–32, 35–39, 41, 42, 45, 47, 50, 51, 53–55, 57, 58]. A subset of studies included a multidisciplinary study team consisting of physicians, general practitioners, a medical officer, case managers, (specialized) nurses, medical record specialists, social workers and/or administrative staff [14, 24, 29, 33, 44, 46, 48]. In three studies senior residents performed the review supervised by a senior physicians [19, 26, 59].…”

Section: Resultsmentioning

confidence: 99%

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How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

Kneepkens

Brouwers

Singotani

et al. 2019

BMC Med Res Methodol

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Background A large number of articles examined the preventability rate of readmissions, but comparison and interpretability of these preventability rates is complicated due to the large heterogeneity of methods that were used. To compare (the implications of) the different methods used to assess the preventability of readmissions by means of medical record review. Methods A literature search was conducted in PUBMED and EMBASE using “readmission” and “avoidability” or “preventability” as key terms. A consensus-based narrative data synthesis was performed to compare and discuss the different methods. Results Abstracts of 2504 unique citations were screened resulting in 48 full text articles which were included in the final analysis. Synthesis led to the identification of a set of important variables on which the studies differed considerably (type of readmissions, sources of information, definition of preventability, cause classification and reviewer process). In 69% of the studies the cause classification and preventability assessment were integrated; meaning specific causes were predefined as preventable or not preventable. The reviewers were most often medical specialist (67%), and 27% of the studies added interview as a source of information. Conclusion A consensus-based standardised approach to assess preventability of readmission is warranted to reduce the unwanted bias in preventability rates. Patient-related and integrated care related factors are potentially underreported in readmission studies. Electronic supplementary material The online version of this article (10.1186/s12874-019-0766-0) contains supplementary material, which is available to authorized users.

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“…This allowed use of their different backgrounds in choosing which elements of the clinical record to focus on. ’ [33]…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

Kneepkens

Brouwers

Singotani

et al. 2019

BMC Med Res Methodol

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“…Particularly in recently discharged patients, optimal followup decreases significantly readmission rates; the implementation of a 7 day follow-up visits programme in a tertiary US hospital as a means of quality improvement resulted in a 30% decrease of HF 30 day readmission rate. 13,14 Regular monitoring may detect disease progression and/or complications or deterioration of symptoms that may require a change in management (e.g. the onset of atrial fibrillation or development of anaemia).…”

Section: Treatment and Follow-up Protocolsmentioning

confidence: 99%

How to develop a national heart failure clinics network: a consensus document of the Hellenic Heart Failure Association

Filippatos¹,

Farmakis²,

Alexanian³

et al. 2020

ESC Heart Failure

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Heart failure (HF) is rapidly growing, conferring considerable mortality, morbidity, and costs. Dedicated HF clinics improve patient outcomes, and the development of a national HF clinics network aims at addressing this need at national level. Such a network should respect the existing health care infrastructures, and according to the capacities of hosting facilities, it can be organized into three levels. Establishing the continuous communication and interaction among the components of the network is crucial, while supportive actions that can enhance its efficiency include involvement of multidisciplinary health care professionals, use of structured HF‐specific documents, such as discharge notes, patient information leaflets, and patient booklets, and implementation of an HF‐specific electronic health care record and database platform.

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“…[26] Two studies found that a quality improvement heart failure checklist tool was effective in lowering readmission rates. [27,28] A 2014 study reviewed literature on successful readmission reduction strategies. This study found that monitoring symptoms after discharge, providing social and community support, and educating patients to promote self-management helps reduce readmissions.…”

Section: Evolution Of Readmission Reduction Strategiesmentioning

confidence: 99%

An environmental analysis of the evolution of readmission reduction strategies: A study of United States hospitals

Upadhyay

Opoku-Agyeman

Borkowski

2017

JHA

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Objective: Environmental factors have changed the manner in which issues in the U.S. healthcare industry are addressed. One of these changes is in the area of quality improvement, specifically readmission reduction. The purpose of this paper is two-fold: (1) analyze macro-environmental segments (political, technological, economic, and socio-demographic); and (2) trace the historic evolution of readmission reduction programs to understand how macro-environmental factors have shaped the development of readmission reduction strategies. Methods: Scopus, PubMed, and ABI/Inform electronic databases were searched for articles on readmission reduction programs from 2000 to 2014. In addition, literature on macro-environment was retrieved from these sources for the same time period. Studies were identified using specific search terms and inclusion criteria. A total of 24 articles were selected for review. Data on the following variables were extracted: type of organization studied, type of quality improvement strategy used, type of patients studied, and results of the strategy. In addition, an examination of macro-environmental factors that may have affected the above variables was done. Finally, results were integrated and presented in a chronological order. Results: Findings suggest that macro-environmental factors have influenced the development of readmission reduction strategies over time. This paper informs healthcare managers about being cognizant of environmental trends when devising readmission reduction strategies within hospitals. Conclusions: Insights from this paper urge hospital administrators to forge collaborations with key stakeholders while developing new quality improvement strategies when facing an unstable and complex environment.

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Preventability of 30-Day Readmissions for Heart Failure Patients Before and After a Quality Improvement Initiative

Cited by 10 publications

References 28 publications

How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

How do studies assess the preventability of readmissions? A systematic review with narrative synthesis

How to develop a national heart failure clinics network: a consensus document of the Hellenic Heart Failure Association

An environmental analysis of the evolution of readmission reduction strategies: A study of United States hospitals

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