Impact of Heart Failure Education on Readmission Rates

Background: Heart failure (HF) is the leading cause of global morbidity and mortality. The epidemic has an increasing incidence in the United States, as one the most common complex cardiovascular diseases. Research demonstrates that pre-discharge, patient-centered HF education has a substantial impact on patient health outcomes. Education ensures patient’s comprehension of their disease process and facilitates behavior alterations leading to a reduction in hospital readmissions. Objective: The purpose of this quality improvement (QI) project was to evaluate the impact of an inpatient HF nurse-led education consult on guideline directed medical therapy (GDMT) titration, patient ejection fraction (EF) readings, and the occurrence of HF hospital readmission rates to improve knowledge regarding trends in readmissions. Methods: A retrospective chart analysis of de-identified patient data was accumulated on thirty-nine patients admitted with a HF diagnosis from an acute care hospital system in the southwestern United States. A statistical comparison between patients that received a pre-discharge education consult with those who did not was emphasized. Additionally, EF readings, the titration of GDMT, and the occurrence of hospital readmission(s) within the 120-day follow-up period were assessed. Results: Data analysis was captured through descriptive statistics, Chi-square tests and Paired t-test. Thirty-nine patients were assessed in the study with 18 patients (46%) receiving a HF nurse education consult. The critical 30-day readmission time period demonstrated 15 readmissions, with 8 (44%) having had an education consult. The occurrence of HF readmission was greatest for those who did not receive a consult at the 31-to-90-day time period (n = 10). GDMT was below guideline recommendations at 120 days, with 15% (n = 6) patients on the four pillars of treatment, with 16% (n = 3) patients having received a HF education consult. Conclusion: This study has demonstrated that the current education program had little impact on the improvement of GDMT, patient EF readings, and HF readmission rates. Further research is needed to determine if current patient education can improve the measured outcomes. Moreover, additional research is essential to investigate the causes for decreased GDMT administration.