Implementation of the GWTG-HF discharge checklist was associated with improved GDMT adherence and a 30-day readmission rate of 17.9% compared to a historical baseline of 22.3%.
Observational (n=56)
No
Does the implementation of a standardized HF discharge checklist improve GDMT adherence and reduce 30-day readmissions in adult inpatients with heart failure?
Implementation of a standardized HF discharge checklist is feasible and associated with improved GDMT adherence and a modest reduction in 30-day readmissions.
Absolute Event Rate: 17.9% vs 22.3%
BACKGROUND Heart failure (HF) is a leading driver of 30-day hospital readmissions in the United States. Suboptimal discharge prescribing of guideline-directed medical therapy (GDMT) contributes to poor outcomes, and standardized discharge processes may improve reliability.² OBJECTIVES: This quality improvement project aimed to reduce 30-day HF readmissions below the CMS benchmark and improve GDMT adherence using the American Heart Association's Get With The Guidelines-Heart Failure (GWTG-HF) checklist. METHODS This prospective quality improvement project implemented a standardized HF discharge checklist for adult inpatients with a diagnosis of heart failure from January through March 2025. Primary outcomes were discharge on ≥3 GDMT medication classes and 30-day all-cause readmissions. Because patient-level data for the immediately preceding quarter were unavailable, the comparator readmission rate was the hospital's most recent internally reported baseline. Implementation used Model for Improvement/Plan-Do-Study-Act cycles, and analyses were descriptive. RESULTS Fifty-six patients were included during the implementation period. The proportion of patients discharged on three or more classes of guideline-directed medical therapy increased following checklist implementation. Ten patients (10/56; 17.9 %; 95 % CI, 10.0 %-30.1 %) were readmitted within 30 days of discharge, compared with the hospital's most recent pre-implementation 30-day heart failure readmission rate of 22.3 %, derived from aggregated institutional quality reports. Quarter-specific numerator and denominator data for the pre-implementation period were not available. The observed post-implementation readmission rate was below the 2024 CMS benchmark (20.2 %). CONCLUSIONS Implementation of a standardized HF discharge checklist was feasible and associated with improved GDMT adherence and a modest reduction in short-term readmissions. These findings highlight the value of structured discharge implementation strategies while underscoring the influence of patient complexity and contextual factors on readmission outcomes.
Walker et al. (Fri,) conducted a observational in Heart failure (n=56). Get With The Guidelines-Heart Failure (GWTG-HF) discharge checklist vs. Historical baseline (pre-implementation) was evaluated on Discharge on ≥3 GDMT medication classes and 30-day all-cause readmissions (95% CI 10.0-30.1). Implementation of the GWTG-HF discharge checklist was associated with improved GDMT adherence and a 30-day readmission rate of 17.9% compared to a historical baseline of 22.3%.