TY - JOUR
T1 - Obtaining a follow-up appointment before discharge protects against readmission for patients with acute coronary syndrome and heart failure
T2 - A quality improvement project
AU - Baky, Vidagay
AU - Moran, Dane
AU - Warwick, Tessa
AU - George, Alice
AU - Williams, Tammy
AU - McWilliams, Eric
AU - Marine, Joseph
PY - 2018/4/15
Y1 - 2018/4/15
N2 - Background: Cardiac patients have a high risk of readmission following hospital discharge. The aim of our project was to examine the factors associated with increased readmission rate, with a view to eventually decrease the rate of readmission for patients admitted to the hospital due to acute coronary syndrome (ACS) or heart failure. Methods: Patients admitted to the cardiac step-down unit at a single private hospital from 2015 to 2016 were included in our study. Interventions that were employed included: (1) improved pre-discharge follow-up appointment scheduling, (2) medication education by a pharmacist, and (3) timely discharge planning. Our primary outcome of interest was all-cause rate of hospital readmission within 30 days. We conducted a multivariate analysis to determine the factors that were predictive of readmission rate. Results: 578 patients were included in the study and 402 were diagnosed with ACS (69.9%). The rate of readmission was 14.2% for patients with heart failure, compared to 7.5% for patients with ACS. Following the bundle of interventions, patients were significantly more likely to receive an appointment (45.6% vs. 75.4%, p < 0.001), medication education from a pharmacist (38.5% vs. 56.7%, p = 0.006), and a timely discharge (47.1% vs. 76.0%, p < 0.001). Readmission rate was comparable following the intervention (8.6% vs. 9.7%), but patients that received an appointment had 0.374 times lower odds of being readmitted (p = 0.004). Conclusions: While our package of interventions did not lead to a significant decline in our readmission rate, patients who received a follow-up appointment prior to discharge were strongly protected against readmission.
AB - Background: Cardiac patients have a high risk of readmission following hospital discharge. The aim of our project was to examine the factors associated with increased readmission rate, with a view to eventually decrease the rate of readmission for patients admitted to the hospital due to acute coronary syndrome (ACS) or heart failure. Methods: Patients admitted to the cardiac step-down unit at a single private hospital from 2015 to 2016 were included in our study. Interventions that were employed included: (1) improved pre-discharge follow-up appointment scheduling, (2) medication education by a pharmacist, and (3) timely discharge planning. Our primary outcome of interest was all-cause rate of hospital readmission within 30 days. We conducted a multivariate analysis to determine the factors that were predictive of readmission rate. Results: 578 patients were included in the study and 402 were diagnosed with ACS (69.9%). The rate of readmission was 14.2% for patients with heart failure, compared to 7.5% for patients with ACS. Following the bundle of interventions, patients were significantly more likely to receive an appointment (45.6% vs. 75.4%, p < 0.001), medication education from a pharmacist (38.5% vs. 56.7%, p = 0.006), and a timely discharge (47.1% vs. 76.0%, p < 0.001). Readmission rate was comparable following the intervention (8.6% vs. 9.7%), but patients that received an appointment had 0.374 times lower odds of being readmitted (p = 0.004). Conclusions: While our package of interventions did not lead to a significant decline in our readmission rate, patients who received a follow-up appointment prior to discharge were strongly protected against readmission.
KW - Acute coronary syndrome
KW - Heart failure
KW - Patient readmission
KW - Quality improvement
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U2 - 10.1016/j.ijcard.2017.10.036
DO - 10.1016/j.ijcard.2017.10.036
M3 - Article
C2 - 29506682
AN - SCOPUS:85042642650
VL - 257
SP - 12
EP - 15
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -