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Implementation of a Multimodal Heart Failure Management Protocol in a Skilled Nursing Facility
Hospitals and skilled nursing facilities (SNFs) are incentivized to reduce hospital readmissions among patients with heart failure (HF). We used the RE-AIM framework and mixed quantitative and qualitative data to evaluate the implementation of a multimodal HF management protocol (HFMP) administered...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900649/ https://www.ncbi.nlm.nih.gov/pubmed/36755744 http://dx.doi.org/10.1177/23337214221149274 |
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author | Rockwell, Michelle S. Cox, Emily Locklear, Tonja Hodges, Brandy Mulkey, Stacey Evans, Brandon Epling, John W. Stavola, Anthony R. |
author_facet | Rockwell, Michelle S. Cox, Emily Locklear, Tonja Hodges, Brandy Mulkey, Stacey Evans, Brandon Epling, John W. Stavola, Anthony R. |
author_sort | Rockwell, Michelle S. |
collection | PubMed |
description | Hospitals and skilled nursing facilities (SNFs) are incentivized to reduce hospital readmissions among patients with heart failure (HF). We used the RE-AIM framework and mixed quantitative and qualitative data to evaluate the implementation of a multimodal HF management protocol (HFMP) administered in a SNF in 2021. Over 90% of eligible patients were enrolled in the HFMP (REACH). Of the 42 enrolled patients (61.9% female, aged 81.9 ± 8.9 years, 9.5% Medicaid), 2 (4.8%) were readmitted within 30 days of hospital discharge and 4 (9.5%) were readmitted within 30 days of SNF discharge compared with historical (2020) rates of 16.7% and 22.2%, respectively (a potential savings of $132,418–$176,573 in hospital costs) (EFFECTIVENESS). Although stakeholder feedback about ADOPTION and IMPLEMENTATION was largely positive, challenges associated with clinical data collection, documentation, and staff turnover were described. Findings will inform refinement of the HFMP to facilitate further testing and sustainability (MAINTENANCE). |
format | Online Article Text |
id | pubmed-9900649 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-99006492023-02-07 Implementation of a Multimodal Heart Failure Management Protocol in a Skilled Nursing Facility Rockwell, Michelle S. Cox, Emily Locklear, Tonja Hodges, Brandy Mulkey, Stacey Evans, Brandon Epling, John W. Stavola, Anthony R. Gerontol Geriatr Med Article Hospitals and skilled nursing facilities (SNFs) are incentivized to reduce hospital readmissions among patients with heart failure (HF). We used the RE-AIM framework and mixed quantitative and qualitative data to evaluate the implementation of a multimodal HF management protocol (HFMP) administered in a SNF in 2021. Over 90% of eligible patients were enrolled in the HFMP (REACH). Of the 42 enrolled patients (61.9% female, aged 81.9 ± 8.9 years, 9.5% Medicaid), 2 (4.8%) were readmitted within 30 days of hospital discharge and 4 (9.5%) were readmitted within 30 days of SNF discharge compared with historical (2020) rates of 16.7% and 22.2%, respectively (a potential savings of $132,418–$176,573 in hospital costs) (EFFECTIVENESS). Although stakeholder feedback about ADOPTION and IMPLEMENTATION was largely positive, challenges associated with clinical data collection, documentation, and staff turnover were described. Findings will inform refinement of the HFMP to facilitate further testing and sustainability (MAINTENANCE). SAGE Publications 2023-02-03 /pmc/articles/PMC9900649/ /pubmed/36755744 http://dx.doi.org/10.1177/23337214221149274 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Rockwell, Michelle S. Cox, Emily Locklear, Tonja Hodges, Brandy Mulkey, Stacey Evans, Brandon Epling, John W. Stavola, Anthony R. Implementation of a Multimodal Heart Failure Management Protocol in a Skilled Nursing Facility |
title | Implementation of a Multimodal Heart Failure Management Protocol in a
Skilled Nursing Facility |
title_full | Implementation of a Multimodal Heart Failure Management Protocol in a
Skilled Nursing Facility |
title_fullStr | Implementation of a Multimodal Heart Failure Management Protocol in a
Skilled Nursing Facility |
title_full_unstemmed | Implementation of a Multimodal Heart Failure Management Protocol in a
Skilled Nursing Facility |
title_short | Implementation of a Multimodal Heart Failure Management Protocol in a
Skilled Nursing Facility |
title_sort | implementation of a multimodal heart failure management protocol in a
skilled nursing facility |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900649/ https://www.ncbi.nlm.nih.gov/pubmed/36755744 http://dx.doi.org/10.1177/23337214221149274 |
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