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A local quality initiative to improve follow-up times for patients with heart failure

Introduction Heart failure is the most common cause of hospital admission in patients >65 years and around 50% of patients will be readmitted within 6 months. Inability to achieve timely outpatient follow-up may contribute to the high rates of avoidable rehospitalisation for this group of patient...

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Autores principales: Schofield, Toni, Duero Posada, Juan, Foroutan, Farid, Alba, Ana Carolina, McDonald, Michael, Linghorne, Meredith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699116/
https://www.ncbi.nlm.nih.gov/pubmed/29450270
http://dx.doi.org/10.1136/bmjoq-2017-000052
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author Schofield, Toni
Duero Posada, Juan
Foroutan, Farid
Alba, Ana Carolina
McDonald, Michael
Linghorne, Meredith
author_facet Schofield, Toni
Duero Posada, Juan
Foroutan, Farid
Alba, Ana Carolina
McDonald, Michael
Linghorne, Meredith
author_sort Schofield, Toni
collection PubMed
description Introduction Heart failure is the most common cause of hospital admission in patients >65 years and around 50% of patients will be readmitted within 6 months. Inability to achieve timely outpatient follow-up may contribute to the high rates of avoidable rehospitalisation for this group of patients. Canadian guidelines recommend patients with heart failure should be seen within 14 days of discharge. Methods An audit demonstrated that less than half of advanced heart failure patients were being followed up within 14 days. In an effort to improve postdischarge follow-up in our heart function clinic, we used process mapping and applied a series of iterative changes to the appointment booking system using Plan–Do–Study–Act cycles to reduce waste and standardise. Results The primary outcome measure, tracked over a period of 20 months, was percentage of patients booked within 14 days. At baseline, 37% of patients were seen within 14 days. After our series of interventions related to streamlining and standardising the appointment booking process, 77% of patients were seen within 14 days and 100% of patients were seen within 21 days. Conclusion The changes made to the appointment booking process were reproducible, sustainable, effective and required no additional resources or funding.
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spelling pubmed-56991162018-02-15 A local quality initiative to improve follow-up times for patients with heart failure Schofield, Toni Duero Posada, Juan Foroutan, Farid Alba, Ana Carolina McDonald, Michael Linghorne, Meredith BMJ Open Qual BMJ Quality improvement report Introduction Heart failure is the most common cause of hospital admission in patients >65 years and around 50% of patients will be readmitted within 6 months. Inability to achieve timely outpatient follow-up may contribute to the high rates of avoidable rehospitalisation for this group of patients. Canadian guidelines recommend patients with heart failure should be seen within 14 days of discharge. Methods An audit demonstrated that less than half of advanced heart failure patients were being followed up within 14 days. In an effort to improve postdischarge follow-up in our heart function clinic, we used process mapping and applied a series of iterative changes to the appointment booking system using Plan–Do–Study–Act cycles to reduce waste and standardise. Results The primary outcome measure, tracked over a period of 20 months, was percentage of patients booked within 14 days. At baseline, 37% of patients were seen within 14 days. After our series of interventions related to streamlining and standardising the appointment booking process, 77% of patients were seen within 14 days and 100% of patients were seen within 21 days. Conclusion The changes made to the appointment booking process were reproducible, sustainable, effective and required no additional resources or funding. BMJ Publishing Group 2017-09-24 /pmc/articles/PMC5699116/ /pubmed/29450270 http://dx.doi.org/10.1136/bmjoq-2017-000052 Text en © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle BMJ Quality improvement report
Schofield, Toni
Duero Posada, Juan
Foroutan, Farid
Alba, Ana Carolina
McDonald, Michael
Linghorne, Meredith
A local quality initiative to improve follow-up times for patients with heart failure
title A local quality initiative to improve follow-up times for patients with heart failure
title_full A local quality initiative to improve follow-up times for patients with heart failure
title_fullStr A local quality initiative to improve follow-up times for patients with heart failure
title_full_unstemmed A local quality initiative to improve follow-up times for patients with heart failure
title_short A local quality initiative to improve follow-up times for patients with heart failure
title_sort local quality initiative to improve follow-up times for patients with heart failure
topic BMJ Quality improvement report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5699116/
https://www.ncbi.nlm.nih.gov/pubmed/29450270
http://dx.doi.org/10.1136/bmjoq-2017-000052
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