Effectiveness of a transition plan at discharge of patients hospitalized with heart failure: a before-and-after study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_90260230B43D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Effectiveness of a transition plan at discharge of patients hospitalized with heart failure: a before-and-after study.
Périodique
ESC heart failure
Auteur(s)
Garnier A., Rouiller N., Gachoud D., Nachar C., Voirol P., Griesser A.C., Uhlmann M., Waeber G., Lamy O.
ISSN
2055-5822 (Electronic)
ISSN-L
2055-5822
Statut éditorial
Publié
Date de publication
08/2018
Peer-reviewed
Oui
Volume
5
Numéro
4
Pages
657-667
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
We evaluated the effectiveness of a multidisciplinary transition plan to reduce early readmission among heart failure patients.
We conducted a before-and-after study in a tertiary internal medicine department, comparing 3 years of retrospective data (pre-intervention) and 13 months of prospective data (intervention period). Intervention was the introduction in 2013 of a transition plan performed by a multidisciplinary team. We included all consecutive patients hospitalized with symptomatic heart failure and discharged to home. The outcomes were the fraction of days spent in hospital because of readmission, based on the sum of all days spent in hospital, and the rate of readmission. The same measurements were used for those with potentially avoidable readmissions. Four hundred thirty-one patients were included and compared with 1441 patients in the pre-intervention period. Of the 431 patients, 138 received the transition plan while 293 were non-completers. Neither the fraction of days spent for readmissions nor the rate of readmission decreased during the intervention period. However, non-completers had a higher rate of the fraction of days spent for 30 day readmission (19.2% vs. 16.1%, P = 0.002) and for potentially avoidable readmission (9.8% vs. 13.2%, P = 0.001). The rate of potentially avoidable readmission decreased from 11.3% (before) to 9.9% (non-completers) and 8.7% (completers), reaching the adjusted expected range given by SQLape® (7.7-9.1%).
A transition plan, requiring many resources, could decrease potentially avoidable readmission but shows no benefit on overall readmission. Future research should focus on potentially avoidable readmissions and other indicators such as patient satisfaction, adverse drug events, or adherence.
Mots-clé
Aged, Female, Follow-Up Studies, Heart Failure/therapy, Humans, Length of Stay/trends, Male, Patient Discharge/trends, Patient Readmission/trends, Reproducibility of Results, Retrospective Studies, Switzerland, Time Factors, Transitional Care/organization & administration, Discharge plan, Heart failure, Potentially avoidable readmission, Readmission, Transitional care
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/05/2018 18:42
Dernière modification de la notice
20/08/2019 15:53
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