Cargando…
A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure
BACKGROUND: The management of patients with cancer and concurrent heart failure (HF) is challenging. The increased complexity of treatment and the occurrence of multiple overlapping symptoms may lead to frequent hospital admissions, which may result in cancer treatment delays, a diminished quality o...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048036/ https://www.ncbi.nlm.nih.gov/pubmed/32154012 http://dx.doi.org/10.1186/s40959-019-0041-x |
_version_ | 1783502225281122304 |
---|---|
author | Fadol, Anecita Estrella, Joylynmae Shelton, Valerie Zaghian, Maryam Vanbenschop, Diane Counts, Valerie Mendoza, Tito R. Rubio, David Johnston, Patricia A. |
author_facet | Fadol, Anecita Estrella, Joylynmae Shelton, Valerie Zaghian, Maryam Vanbenschop, Diane Counts, Valerie Mendoza, Tito R. Rubio, David Johnston, Patricia A. |
author_sort | Fadol, Anecita |
collection | PubMed |
description | BACKGROUND: The management of patients with cancer and concurrent heart failure (HF) is challenging. The increased complexity of treatment and the occurrence of multiple overlapping symptoms may lead to frequent hospital admissions, which may result in cancer treatment delays, a diminished quality of life, and an increased financial burden for the patient’s family. To provide holistic care to oncology patients with HF, we implemented the Heart Success Program (HSP), a patient-centered, interprofessional collaborative practice, which decreased the 30-day hospital readmission rate for HF diagnosis from 40 to 27%. However, this rate remains higher than that reported for Medicare beneficiaries. AIM: To identify the factors contributing to frequent readmissions, the HSP committee participated in the institution’s Clinical Safety and Effectiveness and utilize quality improvement methodologies and tools to decrease hospital readmission for HF. METHODS: The DMAIC (Define, Measure, Analyze, Improve and Control) method was used to guide this quality improvement. Areas considered as having high impact and requiring low effort to address were patient education barriers, lack of documentation clarity, and care provider knowledge gaps about the HSP. We implemented workflow changes, improved clarity with documentation of HF diagnosis, and increase provider knowledge about the HSP. FINDINGS: After 6 months of implementing quality improvement techniques, the 30-day hospital readmission rate for HF patients fell by 23.43% (from 31.7% for the baseline period to 8.27%), exceeding the target project goal of 10%. Our quality improvement method may also be effective in improving the management of patients with cancer and other comorbid conditions. |
format | Online Article Text |
id | pubmed-7048036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70480362020-03-09 A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure Fadol, Anecita Estrella, Joylynmae Shelton, Valerie Zaghian, Maryam Vanbenschop, Diane Counts, Valerie Mendoza, Tito R. Rubio, David Johnston, Patricia A. Cardiooncology Short Communication BACKGROUND: The management of patients with cancer and concurrent heart failure (HF) is challenging. The increased complexity of treatment and the occurrence of multiple overlapping symptoms may lead to frequent hospital admissions, which may result in cancer treatment delays, a diminished quality of life, and an increased financial burden for the patient’s family. To provide holistic care to oncology patients with HF, we implemented the Heart Success Program (HSP), a patient-centered, interprofessional collaborative practice, which decreased the 30-day hospital readmission rate for HF diagnosis from 40 to 27%. However, this rate remains higher than that reported for Medicare beneficiaries. AIM: To identify the factors contributing to frequent readmissions, the HSP committee participated in the institution’s Clinical Safety and Effectiveness and utilize quality improvement methodologies and tools to decrease hospital readmission for HF. METHODS: The DMAIC (Define, Measure, Analyze, Improve and Control) method was used to guide this quality improvement. Areas considered as having high impact and requiring low effort to address were patient education barriers, lack of documentation clarity, and care provider knowledge gaps about the HSP. We implemented workflow changes, improved clarity with documentation of HF diagnosis, and increase provider knowledge about the HSP. FINDINGS: After 6 months of implementing quality improvement techniques, the 30-day hospital readmission rate for HF patients fell by 23.43% (from 31.7% for the baseline period to 8.27%), exceeding the target project goal of 10%. Our quality improvement method may also be effective in improving the management of patients with cancer and other comorbid conditions. BioMed Central 2019-06-10 /pmc/articles/PMC7048036/ /pubmed/32154012 http://dx.doi.org/10.1186/s40959-019-0041-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Short Communication Fadol, Anecita Estrella, Joylynmae Shelton, Valerie Zaghian, Maryam Vanbenschop, Diane Counts, Valerie Mendoza, Tito R. Rubio, David Johnston, Patricia A. A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title | A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title_full | A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title_fullStr | A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title_full_unstemmed | A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title_short | A quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
title_sort | quality improvement approach to reducing hospital readmissions in patients with cancer and heart failure |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048036/ https://www.ncbi.nlm.nih.gov/pubmed/32154012 http://dx.doi.org/10.1186/s40959-019-0041-x |
work_keys_str_mv | AT fadolanecita aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT estrellajoylynmae aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT sheltonvalerie aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT zaghianmaryam aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT vanbenschopdiane aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT countsvalerie aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT mendozatitor aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT rubiodavid aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT johnstonpatriciaa aqualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT fadolanecita qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT estrellajoylynmae qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT sheltonvalerie qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT zaghianmaryam qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT vanbenschopdiane qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT countsvalerie qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT mendozatitor qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT rubiodavid qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure AT johnstonpatriciaa qualityimprovementapproachtoreducinghospitalreadmissionsinpatientswithcancerandheartfailure |