Abstract 180: Use of Hospital Teams Tasked to Reduce Readmissions in the VA

Abstract

Objective: The Department of Veterans Affairs (VA) joined the American College of Cardiology and the Institute for Health Care Improvement’s in their Hospital To Home (H2H) initiative. This initiative attempts to improve the transition of care following discharge for patients with acute myocardial infarction and Heart Failure. The Chronic Heart Failure (CHF) Quality Enhancement Research Initiative (QUERI) worked with providers at each VA hospital to encourage facility enrollment. Ultimately, 86 VA facilities enrolled. The purpose of this study was to determine the extent of existing quality improvement projects in place at each of the 86 enrolled facilities. Method: Contacts at each of the 86 VA facilities enrolled in H2H were asked to complete a web-based survey. This survey focused on each facility’s QI efforts that were currently in place for all their heart failure patients. We had a 93% (n=80) response rate from these facilities. Results: Findings showed that QI national initiatives that the VA facilities joined included H2H (76%), Re-Engineered Discharge (RED) Project (11%), Transitional Care Model (10%) and other local or regional collaboratives (31%). Of note, 81% (n=65) of the facilities had QI teams devoted to reducing preventable readmissions for patients with heart failure. These QI teams included a variety of staff: 89% included physicians, 83% included nurses, 74% included advanced practice nurses or physician assistants, 74% included QI/quality management staff, 63% included pharmacists, and 57% included senior management of the hospital. Conclusions: Many VA facilities have teams devoted to preventing r eadmissions for heart failure. These teams almost always include physicians in addition to managers and other providers. Facilities often participate in multiple national initiatives to improve their goal of reducing readmissions.