Six steps could cut heart failure readmissions

There are six procedural things hospital teams can do to help heart failure patients avoid another hospital stay in the 30 days after they're discharged—and if all six are followed, patients are even more likely to avoid readmission, according to new research in the American Heart Association's journal Circulation: Cardiovascular Quality and Outcomes.

Each step alone had some impact, but researchers discovered that if all six recommendations are followed, readmissions could drop as much as 2 percent. The study's lead author said that may seem like a small number, but the significance is enormous.

"A million people are hospitalized with heart failure each year and about 250,000 will be back in the hospital within a month," said Elizabeth H. Bradley, Ph.D., professor of public health and faculty director of the Yale Global Health Leadership Institute at Yale University in New Haven, Conn. "If we could keep even 2 percent of them from coming back to the hospital, that could equal a savings of more than $100 million a year."

Heart failure hospital readmissions are common and a major contributor to rising healthcare costs. Bradley and her team sought ways to cut that, and identified six steps as most effective:

• Forming partnerships with community doctors to address readmission issues.
• Collaborating with other hospitals to develop consistent strategies for reducing readmission.
• Having nurses supervise the coordination of medication plans.
• Scheduling follow-up appointments before patients leave the hospital.
• Developing systems to forward discharge information to the patient's primary care doctor.
• Contacting patients on all test results received after they are discharged.

The researchers analyzed nearly 600 hospital surveys, given between November 2010 and May 2011, from two nationwide programs aimed at reducing hospital readmissions for heart failure.

Fewer than 30 percent of the hospitals followed most of the steps, and only 7 percent used all six.

"Our findings highlight the importance of the full system of care and the value of coordination among providers for addressing readmissions," Bradley said. "Hospitals and their patients would benefit from considering these six strategies and starting to implement them."