Multidisciplinary rounds in prevention of 30-day readmissions and decreasing length of stay in heart failure patients: A community hospital based retrospective study


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Abstract

To assess the impact of multidisciplinary rounds (MDR) on 30-day readmissions and length of stay in hospitalized patients with a diagnosis of congestive heart failure in a community teaching hospital.Patients with primary admission diagnosis of congestive heart failure (CHF) were included. A before and after retrospective study was conducted once the intervention was implemented in 2014. The before and after study periods were each of 1-year duration and included 181 and 151 patients, respectively. Our multidisciplinary heart failure rounding team consisted of a staff cardiologist, case manager, pharmacist, social worker, and a nutritionist.The mean length of stay decreased from 5.7 days to 5 days, and 30-day readmissions decreased from 27.6% to 17.22% (P-value .026) after implementation of the multidisciplinary rounding. We observed a significant decrease of readmissions in ischemic cardiomyopathy (ICM) (from 33.61% to 14.01%; P-value .007) and heart failure with reduced ejection fraction (HFrEF) (from 31.34% to 16.05%; P-value .028) patients. There was an increase in the percentage of patients hospitalized with non-ischemic cardiomyopathy (NICM) and heart failure with preserved ejection fraction (HFpEF) and, in particular, women patients with heart failure.Implementation of MDR program on CHF patients resulted in significant decrease in both readmission rate and length of stay in our hospital.

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