Objectives: Heart failure [HF] hospital readmissions are a continued challenge in the care of HF patients, which contribute substantially to the high costs of the disease and high mortality rate in lower to middle income country. We implemented a quality improvement project to improve patient outcomes and resource utilization. Methods: This study was a prospective cohort design with a historical comparison group. It was conducted to assess the difference in 30-day readmissions and mortality and to assess compliance rate with HF guideline between the historical pre-intervention audit 1 cohort and prospective post-intervention audit 2 cohorts. Audit 1 cohort were recruited from January to February 2019, whereas, audit 2 cohort which received the bundled intervention program were recruited from July to December 2019. Clinical outcomes were compared between cohorts using 30-day readmissions and mortality. Results: A total of 50 and 164 patients were included in audit 1 and audit 2 cohort, respectively. Patients in the audit 2 cohort were younger [63.0 ± 14.5 in audit 1 vs 56.5 ± 12.7 in audit 2, p ¼ 0.003] and majority were male [50.0% in audit 1 vs 72.0% in audit2, p ¼ 0.004]. Thirty-day readmissions were significantly different [36.0% audit 1 vs. 22.0% audit 2, p ¼ 0.045], but the mortality rates were similar [4.0%% audit 1 vs. 5.5% audit 2, p ¼ 0.677] between two cohorts. Conclusion: A significant decrease in 30-day readmissions was observed in the post-intervention audit 2 cohort in our setting. Further study in larger population and prolong study follow-up is warranted.
Hoo, Yee Yin; Mazlan-Kepli, Wardati; Hasan, Wan Nurul Huda Wan; Chen, Fan Jie; Devadas, Prashanthini; Chow, Yan Yee; Sow, Qian Yi; Azizan, Azrol Amar; Muizz Abd Malek, Abdul; Seng Kiong Lau, Glendon; and Chua, Ping Lik
"A Quality Improvement Approach to Reduce 30-Day Readmissions and Mortality in Patients with Acute Decompensated Heart Failure,"
Journal of the Saudi Heart Association: Vol. 33
, Article 5.
Available at: https://doi.org/10.37616/2212-5043.1247
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