Improving Heart Failure Discharge Care Through a Resident-Led Quality Improvement Initiative

Guideline-directed medical therapy (GDMT) substantially reduces hospitalization and mortality in heart failure (HF), yet 30-day readmission rates remain high.

HF readmissions are multifactorial, and not all contributors are modifiable during hospitalization. Residents are well positioned to influence discharge-level care by reinforcing patient education, identifying barriers to GDMT initiation and thereby addressing readmission.

A resident-led quality improvement initiative standardized HF discharge education using teach-back methods and incorporated individualized GDMT eligibility review. Among patients receiving resident-led education, the observed 30-day all-cause readmission rate was 11.7%, compared with a hospital-wide baseline rate of 23.0%. Among patients with HF with reduced ejection fraction, 46.2% were discharged on GDMT, most limited by hypotension or acute kidney injury.

A resident-led initiative focused on discharge education and GDMT review offers a practical, reproducible, low-resource strategy to address modifiable barriers to optimal therapy and, by extension, readmission.