Chronic heart failure annually impacts approximately 5.7 million individuals in the United States, resulting in a financial burden of over $30.7 billion due to healthcare expenses and treatment costs (Taklalsingh et al., 2020). According to Driscoll et al. (2020), the annual survival rate for hospital admissions is only 30-40%, suggesting a potential impact on morale. The projected readmission rate within 30 days is 23% for patients. The Hospital Readmissions Reduction Program was initiated by the Centers for Medicare & Medicaid Services (CMS) in 2012. It aims to reduce avoidable readmissions for heart failure patients by imposing financial penalties on institutions with higher readmission rates following heart failure hospitalizations. These penalties result in lower monthly payments or reimbursements for these institutions. This paper aims to elucidate the identified gap in quality improvement practice.
During this practicum, I observed a deficiency in my practice regarding the 30-day hospitalization rates for congestive cardiac failure. The inclusion of the 30-day readmission rate as a metric for evaluating hospital quality aims to reduce healthcare expenses and prevent inadequate treatment for individuals with heart failure. This study utilized multiple communities to evaluate various metrics, including hospital rating and payment rate, to promote improved care for individuals with congestive heart failure. Healthcare institutions have recognized the importance of maintaining a low 30-day readmission rate to achieve high-quality assessments and receive high reimbursement rates.
As a result, they have enhanced their ability to monitor and provide appropriate treatment to patients with congestive heart failure (Roshanghalb et al., 2019). This research investigates how project execution and root-cause analysis can improve outcomes for individuals with congestive heart failure. This research seeks to utilize the Johns Hopkins Nursing Evidence-Based Practice and the Johns Hopkins Nursing Evidence-Based Practice Translation Tool to identify effective measures or strategies for significantly reducing the 30-day readmission rate among patients with heart problems. Lewin’s theory of managing change is a component of the change management process.
This research evaluates interventions hospitals and healthcare providers can implement to reduce the 30-day readmission rate for cardiac conditions. The proposed intervention seeks to achieve two main objectives.
To meet these goals, the hospital should conduct a root-cause analysis to determine the primary risk factors associated with heart failure readmission rates. Subsequently, intervention recommendations can be made based on this data (Delgado et al., 2019). The objectives of reducing the rate of heart disease readmissions are SMART (specific, measurable, attainable, realistic, and timely), making them feasible to implement within a medical setting.
To fulfill its goals, the facility has to consider two main tactics. Finding the best evidence-based therapies is crucial to lowering the hospital’s readmission rate for heart disease. To accomplish these changes further, change management techniques must be implemented. Project management strategies are needed for both processes (Taklalsingh et al., 2020). Comprehensive home healthcare programs that include round-the-clock phone support for up to 25–30 days after discharge, personalized education on self-care techniques during hospitalization, frequent check-in visits, and encouragement of in-home follow-up are beneficial to patients with heart failure (Cholack et al., 2021).
Through root-cause analysis, a team may use project management tools to evaluate hospitals’ readiness and current procedures to reduce 30-day hospitalization rates linked to cardiac problems. According to the National Patient Safety Foundation (NPSF), root-cause analysis is a valuable method employed by interdisciplinary development teams to identify the underlying causes and explanations for readmissions (Blumer et al., 2021). To reduce cardiovascular disease readmissions, the development team will incorporate change management strategies to implement evidence-based practice improvements
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