Abstract 11358: A Standardized Heart Failure Bundle to Provide Better Patient Care and Reduce Readmissions

Abstract

In adults, heart failure (HF) is associated with increased morbidity and mortality, with projected health care costs of 70 billion by 2030. Evidence-based care identifies that early evaluation and management improves lives and is cost-effective. Streamlining strategies to facilitate care delivery can assist heart failure patients in sustaining their complex lifestyles and behavioral modifications while preventing readmissions. Utilizing a standardized heart failure bundle with evidence-based heart failure care across health systems can provide better care and reduce the 30-day readmission rate. An interdisciplinary team identified a shared need and worked together to set the patient up for success providing a seamless transition of care from inpatient to outpatient. A literature review of evidence-based heart failure care was completed. An Information Systems (IS) team was engaged in creating an HF dashboard to measure interventions and show a return of investments. A Physician Champion was brought into the team to lead the group. A nurse coordinates the initiative while ensuring all aspects are met before discharge. The bundle includes standardized patient education, pharmacy medication reconciliation (MR) before discharge, medication counseling, and HF clinic visit within 10-days of discharge.The Standardized HF bundle begins with identifying heart failure admissions utilizing a readmissions risk report. Next, ensuring medication reconciliation is completed before discharge, as well as medication counseling. A self-management tool engaged patients in care as well. Finally, ensuring the patient has a follow-up appointment within 14 days of discharge. Process metrics evaluated include scheduling and completing follow-up (F/U) appointments and completing medication reconciliation by pharmacy. Before the HF bundle, 72% of F/U appointments were scheduled, and 34.3% were completed in March 2020. MR was 55%. After the HF bundle’s implementation, 95.9% of f/U appointments were scheduled, and 69.2% were completed in March 2021. In addition, mr was 77%. The Outcomes data includes HF readmission rates. The HF readmission rates were 30.4% in early 2020. After the implementation of the HF bundle, the HF readmission rate is 18.5%.