A Smartphone Intervention to Reduce Hospital Readmission Rates in Adult Patients Who Have Heart Failure

Heart failure (HF) is the leading cause of 30-day hospital readmission, with up to 23.5% of Medicare beneficiaries requiring subsequent admission within 30 days post hospital discharge (CMS, 2020a). Mobile-health applications (MHA), such as smartphone applications, have emerged as cost-effective methods to safely manage chronic disease in the outpatient setting (Inglis et al., 2015). The purpose of this evidence-based practice (EBP) project was to evaluate the impact of a MHA on HF-related 30-day readmission rates. The Iowa Model Revised guided the implementation of the project in a rural, for-profit hospital in Northwest Indiana. An extensive literature search was conducted, and a MHA project plan was implemented. Adult inpatients (N = 18) who were admitted with a diagnosis of HF exacerbation were identified through a comprehensive chart review process. A prospective between group comparison design allowed for assessment of thirty-day and 8-week readmission rates for each group. Readmission rate data were analyzed using a one-way multivariate analysis of variance (MANOVA). No significant difference in readmission rates were appreciated between groups (Llambda(2,4) = .804, p \u3e 0.05). To further evaluate if any association existed between the use of the MHA and readmission rates, epidemiologic measures of association were evaluated (OR = 0.156, 95% CI 0.013 - 1.828, p \u3e 0.05, ARR = 0.33; NNT = 3). No statistically significant results were identified. Despite non-significant results of the primary outcomes, clinical significance can be appreciated. Statistically significant differences were noted in pre- (M = 3.81, sd = .654) and postintervention (M = 2.57, sd = .672) selfcare behavior scale scores (t = 4.06, p = 0.005). Findings from this project may be used to further evaluate the use, long-term benefits, and financial implications of MHA interventions on HF-related readmissions