Implementation of a heart failure clinic: strategy for reduction in 30-day readmissions

Purpose: The aim of the project was to start a multi-disciplinary Heart Failure (HF) clinic to reduce 30-day readmissions or ED visits within a large multi-specialty clinic. Methods: In a community hospital in Northeastern Pennsylvania, a team of providers developed a HF clinic to evaluate patients who had recently been discharged from the hospital with a principal admission diagnosis of heart failure. The visit was primarily conducted by one of two heart failure nurse practitioners, in collaboration with a HF registered nurse (RN), and a pharmacist. Framework of this project was guided by the Logic Model. This model is utilized by planners, funders, and evaluators of programs and interventions. The model includes process and outcomes components as well as indicating when to expect certain change. Results: Readmission for HF within 30 days of hospital discharge occurred in 16.92% of patients during the first three months of the study period, in the sample group. In the comparison group, readmission for HF had occurred in 23.62% of patients. Thus, we achieved an absolute risk reduction of 6.03% and a relative risk reduction of 0.26% in 30-day HF readmissions. Conclusion: Our Study demonstrates the feasibility of starting a nurse practitioner lead HF clinic in collaboration with a RN and a pharmacist, with specific intent to reduce 30-day readmissions and ED visits.https://orb.binghamton.edu/research_days_posters_spring2020/1039/thumbnail.jp