Abstract P145: Implementation of a Simple Computerized Heart Failure Discharge Instruction Tool Lead to Increased Adherence to JCAHO Heart Failure Core Measures and Reduced Heart Failure Readmission Rate

Abstract

Background: Suboptimal adherence to JCAHO (Joint Commission on the Accreditation of Healthcare Organizations) heart failure (HF) core measures have been reported in various hospital settings. Non- adherence to JCAHO HF core measures have been associated with decreased survival. The purpose of this study was to evaluate the impact of implementation of a discharge instruction tool on the adherence to JCAHO HF measures and analyze HF outcomes. Methods: A simple computerized discharge instruction tool (DIT) included an electronic check list of four JCAHO HF core measures to be completed and verified by all physicians who discharged acute HF patients; and got implemented at Catholic Medical Center (CMC), New Hampshire from January 2008. We compared the patient data before (January to December 2007; n=219)) and after (January 2008 to June 2009; n=326) implementation of DIT for adherence to four JCAHO HF core measures. All patients were followed for six months to analyze HF readmission rate and cardiac related death. Results: Total eligible patients (n=545) with their adherence to the HF core measures and improvement in the adherence to discharge instructions are shown in Table 1 and Figure 1-a/b. Reduction of six-month readmission rate (36.2 vs 27.8%; p=0.03) recognized an approximate saving of $6500.00 per case accounting to a total annual savings of approximately $176,000; with no significant change in the hospital length of stay and cardiac related death. Conclusions: A simple DIT achieved an improved adherence to JCAHO HF core measures and CMC acquired a local and regional recognition. Similar DIT could be shared in other hospitals across the nation to achieve improved HF outcomes.