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Implementation of a Multimodal Heart Failure Management Protocol in a Skilled Nursing Facility
Michelle S Rockwell1,2, Emily Cox1, Tonja Locklear1
1Carilion Clinic, Roanoke, VA, USA.
Gerontology & Geriatric Medicine
|February 9, 2023
Summary
A new heart failure management protocol in skilled nursing facilities significantly reduced readmissions. This approach shows promise for improving patient care and reducing healthcare costs.
Area of Science:
- Gerontology
- Cardiology
- Healthcare Management
Background:
- Hospitals and skilled nursing facilities (SNFs) face pressure to decrease heart failure (HF) readmissions.
- Effective management protocols are crucial for post-discharge HF patient care.
Purpose of the Study:
- To evaluate the implementation and effectiveness of a multimodal HF management protocol (HFMP) in an SNF setting.
- To assess the impact of the HFMP on hospital readmission rates and associated costs.
Main Methods:
- Utilized the RE-AIM framework with mixed quantitative and qualitative data.
- Evaluated the implementation of an HFMP in an SNF during 2021.
- Compared readmission rates and costs to historical 2020 data.
Main Results:
- Over 90% of eligible patients were enrolled (REACH).
- Reduced 30-day readmissions post-hospital discharge from 16.7% to 4.8%.
- Reduced 30-day readmissions post-SNF discharge from 22.2% to 9.5%, potentially saving $132,418-$176,573.
Conclusions:
- The HFMP demonstrated high patient reach and significant effectiveness in reducing HF readmissions.
- Stakeholder feedback indicated positive adoption and implementation, despite challenges in data collection and staff turnover.
- Findings support refining the HFMP for future testing and long-term sustainability (MAINTENANCE).
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