ModelHeart: a resident-led implementation of metrics to reduce 30-day heart failure readmissions

Postgraduate Medical Journal
Sergey KachurMarlow Hernandez

Abstract

Hospitals have been penalised for excessive 30-day readmissions via Medicare payment penalties. As such there has been keen interest in finding ways of reducing readmissions. The basis for the study was a retrospective review of heart failure (HF) admissions at Cleveland Clinic Florida from 1 January 2010 to 31 December 2010. The result of this was a set of metrics associated with >30 day span between admissions: N-terminal pro-brain natriuretic peptide by at least 23%, fluid balance of ≤-1.3 L and sodium ≥135 mEq/L on discharge. The ModelHeart trial was a prospective resident-led validation of these criteria that consisted of education about and implementation of these metrics. A total of 200 patients carrying a diagnosis of HF, admitted between 1 November 2012 and 14 January 2014 were included in the trial. Of the 200 enrolled patients, 94% of discharged patients met at least one criteria, 58% met at least two criteria and 20% met all three. There were forty-eight all-cause 30-day readmissions. 30-day readmission rates between themore than equal to two criteria cohort and the remaining patients were not significantly different (p=0.71). Overall readmission rates were higher in the 2011-2012 retrospective patient pool (19%) ve...Continue Reading

References

Mar 18, 2004·JAMA : the Journal of the American Medical Association·Christopher O PhillipsHaya R Rubin
Oct 10, 2007·Archives of Internal Medicine·Mihai GheorghiadeChristopher M O'Connor
Apr 30, 2008·Archives of Internal Medicine·Gregg C FonarowUNKNOWN OPTIMIZE-HF Investigators and Hospitals
Oct 24, 2009·Journal of the American College of Cardiology·Soko Setoguchi, Lynne Warner Stevenson
Jun 22, 2010·Circulation. Heart Failure·Lynne Warner StevensonRobert C Bourge
Dec 18, 2010·Professional Case Management·Barbara Jacobs
Feb 15, 2011·Lancet·William T AbrahamUNKNOWN CHAMPION Trial Study Group
Mar 30, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Carl van WalravenAlan J Forster
Jun 23, 2011·Circulation. Cardiovascular Quality and Outcomes·Larry A AllenJohn A Spertus
Dec 6, 2011·Circulation·Serge MassonUNKNOWN Valsartan Heart Failure Trial (Val-HeFT) and Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca–H
Jul 25, 2012·Circulation·Akshay S Desai, Lynne W Stevenson
Apr 26, 2013·Circulation. Heart Failure·Paul A HeidenreichUNKNOWN Stroke Council
Aug 10, 2013·Clinical Cardiology·Marlow B HernandezGian M Novaro
Feb 5, 2014·Journal of the American College of Cardiology·Andrew P AmbrosyMihai Gheorghiade
Oct 8, 2014·Heart Failure Reviews·Brett W SperrySamer S Najjar
Dec 15, 2015·JACC. Heart Failure·Marvin A Konstam, Jenica Upshaw
Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Feb 1, 2015·Cardiology Research·Jill Howie-EsquivelTeresa De Marco

❮ Previous
Next ❯

Citations

Jul 14, 2019·The American Journal of Cardiology·Chun Shing KwokMamas A Mamas

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.