Optimization of Heart Failure Patients Discharge Plan in Rajaie Cardiovascular Medical and Research Center: An Action Research

BACKGROUND: Chronic heart failure can lead to frequent hospitalizations. Improving the discharge planning is an approach to reduce hospitalization. Since there has not been enough structured and effective discharge plan in Iranian hospitals, the present study was designed to optimize this program. METHOD: This is a participatory action research based on Hart and Bond’s framework, conducted in a cardiovascular center in Iran from June 2016 to April 2018 during two cycles. Based on the optimization strategies obtained through semi-structured interviews with 15 participants, three focus group discussions and six expert panels, the operational discharge plan, including three areas of patient empowerment, telephone follow-up and home visit, was designed, implemented for three months and evaluated for 23 patients. European Heart Failure Self-Care Behavior Scale and information registration form to record the number of hospitalization and length of hospital stay were used to collect the quantitative data. The non-parametric Wilcoxon test was used to analyze the data by SPSS 16. Qualitative participatory evaluation was performed during a group discussion and analyzed based on qualitative content analysis method with conventional approach P<0.05 was statistically significant. RESULTS: Considering the solutions provided by the participants, the operational discharge plan was designed and implemented with the cooperation of relevant stakeholders. Evaluation showed significant effects of designed discharge plan on self-care behavior (P<0.001), number of hospitalizations (P<0.001), and length of hospital stay (P<0.001). CONCLUSION: Changes were made to improve the heart failure patients’ discharge plan using action research, which resulted in reduced re-hospitalization and improved self-care behavior.