Improving Health Outcomes Among Patients with CHF Through Implementation of Telehealth Depression Screening and CHF Symptom Management

Abstract Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan. Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the United States remains low. Screening programs for CHF and depression symptoms in patients with CHF may improve patient outcomes while reducing hospital readmission and mortality rates. Methods: This DNP practice improvement project sought to employ telehealth to improve symptom management and reduce hospital readmission rate among CHF patients. The project aimed to assess the benefits of implementing telehealth screening of CHF patients, thus informing practice change in caring for patients diagnosed with CHF. This project also aimed to explore the efficacy of including Patient Health Questionnaire (PHQ-2 and PHQ-9) depression screening, CHF symptom screening, and CHF symptom management in each telehealth visit to improve adherence to treatment plans and health outcomes and to reduce the hospital readmission rate. Results: The findings demonstrated that the rate of CHF-related 30-day readmission decreased substantially from 20.7% rate for the previous year (2022) to 0% after the 8-week implementation of this project. Achieving the goal of less than 20.7% CHF readmission rate will provide significant cost savings for the hospital. Keywords: congestive heart failure, heart failure, CHF, HF, telehealth, outcome, depression, readmission, 30-day readmissio