Home for the Holidays Campaign to Reduce Seasonal Heart Failure Hospitalizations

Abstract

Introduction Heart failure (HF) is a progressive syndrome and previous studies have shown that HF patients are more likely to be hospitalized during colder winter months. These seasonal variations coincide with holidays and can cause an additional emotional burden on patients, family members, and caregivers. Historically, 1 out of 4 HF patients at our institution experienced multiple hospitalizations during this period compared to 1 out of 5 in all other months. Therefore, we created a Home for the Holidays campaign to engage interdisciplinary care teams (IDT) and patients. We hypothesized that these efforts, in conjunction with existing hospital readmission reduction program interventions, would reduce the 30-day all-cause HF readmission rate. Methods A readmission rate goal of less than 15% was established for 23 nursing units across 3 hospital campuses within a large, urban academic health system. Units that achieved this goal received recognition and breakfast with senior executive health system leadership. A toolkit consisting of a low sodium holiday menu, education workbook and magnet advertising the post-discharge helpline were distributed in a tote bag to all patients identified with acute decompensated HF (ADHF). IDT members focused on self-care management and early symptom recognition with patients and caregivers, as well as timely follow-up appointments. Results Between 2014 and 2017 the average 30-day all-cause HF readmission rate for the month of December was 24.3%. In December 2018, 235 patients were admitted for ADHF, 37 patients were subsequently readmitted within 30 days and the readmission rate was 15.7%. The Home for the Holidays campaign contributed to a 35.4% rate reduction (p= 0.046) and 9 units achieved the institutional goal of less than 15%. Conclusions Implementation of the toolkit, along with enhanced counseling and post-discharge follow-up, successfully reduce HF hospital readmissions. Health systems can easily integrate a seasonal campaign to increase awareness and stimulate transitional care and educational activities to keep patients healthy and at home for the holidays.