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Reducing Readmissions After Transcatheter Aortic Valve Replacement Through Enhanced Transitional Care
Misty L Theriot1, Edward C Bergen1, Joseph G Lugo1
1Lake Charles Memorial, Hospital Heart & Vascular Center, Lake Charles, Louisiana, USA.
Insights
Implementing a structured, multidisciplinary transitional care program significantly reduced 30-day readmissions after transcatheter aortic valve replacement (TAVR). This patient-centered approach improved outcomes and reduced healthcare costs.
Area of Science:
- Cardiovascular Medicine
- Healthcare Quality Improvement
- Patient Care Management
Background:
- Transcatheter aortic valve replacement (TAVR) use is increasing, highlighting the need for better care coordination.
- High 30-day readmission rates post-TAVR present significant clinical and financial challenges.
- A 12.7% readmission rate at one institution prompted a quality improvement initiative.
Background:
Transcatheter aortic valve replacement (TAVR) volumes continue to expand, increasing the need for optimized periprocedural and transitional care. Readmissions have substantial clinical and financial impact.
Project Rationale:
In 2018-2019, Lake Charles Memorial Hospital's 30-day post-TAVR readmission rate was 12.7%, with 58% unrelated to valve complications, prompting a quality-improvement initiative.
Project Summary:
A phased, multidisciplinary pathway incorporated standardized discharge education, early follow-up, conduction system disease monitoring, social determinants of health screening with tailored resources provided, and home monitoring for high-risk patients. Guided by Plan-Do-Study-Act cycles, interventions emphasized patient engagement, proactive complication detection, and continuity of care. Post implementation (2022-2025 Q2), readmissions declined to 1.9% despite a higher-risk cohort, with concurrent reductions in length of stay and substantial cost savings.
Take-Home Messages:
Structured, multidisciplinary transitional care can markedly reduce post-TAVR readmissions. Long-term sustainability is supported through patient-centered strategies and integration of social determinants of health-focused interventions.
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