What does this research mean for the field?

A quality-improvement heart failure checklist significantly reduces 30-day and 6-month readmissions and improves medication optimization compared to standard care. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To assess the impact of an inexpensive quality-improvement checklist on physician care quality and readmission rates for patients hospitalized with acute decompensated heart failure.

July 1, 2013Congestive Heart FailureOpen Access

Decreased Readmissions and Improved Quality of Care With the Use of an Inexpensive Checklist in Heart Failure

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Acute decompensated heart failure (n=96). Intervention: Quality-improvement heart failure checklist vs. Randomly selected control group. Primary outcome: 30-day readmission.

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Key result

A quality-improvement heart failure checklist reduced 30-day readmissions (6% vs 19%) and 6-month readmissions (23% vs 42%) compared with a randomly selected control group.

Why the study?

Does a quality-improvement heart failure checklist improve quality of care and reduce readmissions in patients admitted with acute decompensated heart failure?

Population

96 patients admitted with a primary diagnosis of acute decompensated heart failure

Comparison

Quality-improvement heart failure checklist vs Randomly selected control group receiving…

Design

RCT, Randomly selected patients for checklist group and randomly selected…

Follow-up

6 months

Authors

ABAbhijeet BasoorTrinity Health Oakland Hospital NDNitin DoshiTrinity Health Oakland Hospital JCJohn F. CotantTrinity Health Oakland Hospital

Discussion

Member takes

Implication

Supports routine HF discharge checklist use to cut readmissions; provides RCT confirmation of prior observational benefits.

Key Points

To assess the impact of an inexpensive quality-improvement checklist on physician care quality and readmission rates for patients hospitalized with acute decompensated heart failure.
Conducted a trial comparing 48 randomly selected patients managed with an inpatient heart failure checklist against 48 randomly selected controls.
The checklist prompted physicians regarding medication management, dose uptitration, counseling, and post-discharge follow-up instructions.
Evaluated guideline-directed medical therapy prescribing rates and readmissions at 30 days and 6 months.
Prescription of ACE inhibitors or ARBs was higher in the checklist group compared to controls (40/48 vs 23/48, P < .001).
Dose uptitration of beta-blockers and/or ACE inhibitors/ARBs occurred more frequently with the checklist (21/48 vs 4/48, P < .001).
Readmission rates were lower in the checklist arm at 30 days (6% vs 19%) and at 6 months (23% vs 42%).

Study Design

Type

RCT (n=96)

Randomization

Randomly selected

Structured PICO

Does a quality-improvement heart failure checklist improve quality of care and reduce readmissions in patients admitted with acute decompensated heart failure?

Population

96 patients admitted with a primary diagnosis of acute decompensated heart failure

Intervention

Quality-improvement heart failure checklist (including documentation regarding medications, dose uptitration, relevant counseling, and follow-up instructions at discharge)

Comparator

Randomly selected control group receiving standard care

Outcome

Quality of care (medication use and dose uptitration) and readmission rates (30-day and 6-month)hard clinical

Main Result

Absolute Event Rate: 6% vs 19%

The implementation of a simple discharge checklist for patients with acute decompensated heart failure significantly improves guideline-directed medical therapy utilization and reduces both 30-day and 6-month readmission rates.

Cite This Study

Basoor et al. (2013) conducted an RCT in Acute decompensated heart failure (n=96). Quality-improvement heart failure checklist vs. Randomly selected control group was evaluated on 30-day readmission. A quality-improvement heart failure checklist reduced 30-day readmissions (6% vs 19%) and 6-month readmissions (23% vs 42%) compared with a randomly selected control group.

synapsesocial.com/papers/6a156307814bf8ec9a4e8284 https://doi.org/10.1111/chf.12031

Topics

Heart failure HFrEF treatment Heart failure hospitalization HFpEF management

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Decreased Readmissions and Improved Quality of Care With the Use of an Inexpensive Checklist in Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Decreased Readmissions and Improved Quality of Care With the Use of an Inexpensive Checklist in Heart Failure

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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