Implementation of the STELR quality improvement program with resident tracking reduced the heart failure readmission rate from 32% prior to implementation to 21% among tracked patients.
Observational
No
Does a resident-involved heart failure readmission reduction program reduce readmission rates in patients with heart failure?
Implementation of a resident-driven heart failure readmission reduction program successfully decreased hospital readmission rates from 32% to 21% for tracked patients.
Absolute Event Rate: 21% vs 32%
BACKGROUND: Congestive heart failure (CHF) is one of the leading causes of hospital readmissions within 30 days of discharge. Due to the substantial costs associated with these readmissions, several interventions to reduce CHF readmissions have been developed and implemented. METHODS: To reduce CHF readmissions at our community teaching hospital, the Smooth Transitions Equal Less Readmission (STELR) program was developed. Utilizing the Plan-Do-Check-Act cycle for quality improvement, resident physicians tracked patients enrolled in the STELR program. The resident contribution to the program was substantial in that they were able to quantify the improvement in both physician practices and patient readmissions. This provided insight into program areas requiring further modification, which the hospital would not have obtained without resident participation. RESULTS: The readmission rate for patients diagnosed with heart failure decreased from 32% prior to program implementation, to 24% hospital wide (including patients who were not tracked in the STELR program), and 21% among patients tracked by the residents. CONCLUSION: This effective CHF readmission reduction program requires less financial resources compared to government funded programs. The resident involvement in the STELR program helped to assess and improve the program and also allowed the residents to gain an awareness of the resources available to their patients to facilitate their transition home. The program exposed the residents to systems-based practice, a fundamental element of their residency training and, more generally, community care.
Rabbat et al. (Sun,) conducted a observational in Congestive heart failure. Smooth Transitions Equal Less Readmission (STELR) program vs. Pre-implementation (historical control) was evaluated on Hospital readmission rate. Implementation of the STELR quality improvement program with resident tracking reduced the heart failure readmission rate from 32% prior to implementation to 21% among tracked patients.