Risk score-guided multidisciplinary team-based Care for Heart Failure Inpatients is associated with lower 30-day...

Area of Science:

• Cardiology
• Health Services Research
• Clinical Decision Support

Background:

• Heart failure (HF) inpatient care and post-discharge management require quality improvement to enhance patient health and reduce readmissions.
• Optimizing utilization and patient outcomes are key challenges in HF care.

Purpose of the Study:

• To evaluate a multidisciplinary team-based care process (MTCP) guided by augmented intelligence clinical decision tools and risk scores.
• To assess the impact of MTCP on 30-day readmission and 30-day mortality rates for heart failure patients.

Main Methods:

• A stepped-wedge implementation of MTCP across 20 hospitals studied 6,182 HF inpatients from January 2013 to November 2016.
• Risk scores identified high-risk patients who received MTCP, while lower-risk patients received standard care.
• Readmission and mortality outcomes were compared between MTCP recipients and control groups.

Main Results:

• High-risk MTCP recipients experienced a 21% reduction in 30-day readmissions and a 52% reduction in 30-day mortality compared to controls.
• Lower-risk patients showed no significant increase in readmission or mortality.
• Some utilization metrics, like home health prescriptions, increased for MTCP recipients, with no change in length of stay or costs.

Conclusions:

• A risk score-guided MTCP is associated with significantly lower 30-day readmission and mortality rates in high-risk heart failure inpatients.
• Further research is warranted to fully evaluate this clinical management approach for heart failure.
• The MTCP demonstrates potential for improving outcomes in heart failure care.