A558 JACC April 1, 2014 Volume 63, Issue 12 Congenital Heart Disease CONGESTIVE HEART FAILURE: OPENING DOORS OUTPATIENT TO PREVENT MANAGEMENT INPATIENT Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m. Session Title: Heart Failure and Cardiomyopathies: Challenge of Acute Decompensated Heart Failure Abstract Category: 12. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1186-200 Authors: Mrinalini Krishnan, Kamran Uddin, Leilani Garcia, Yijin Wert, Pramil Cheriyath, PinnacleHealth Hospital, Harrisburg, PA, USA Background: Congestive Heart Failure (CHF) is a chronic medical condition accounting for numerous hospital admissions for exacerbations each year. Hospitals have established various outpatient walk-in and “fast-track” clinics in hopes of preventing hospital readmissions. We hypothesized that implementing such alternative outpatient evaluation facilities would reduce 30-day readmissions for CHF exacerbations. Methods: A retrospective chart review was done of 93 patients with Congestive Heart Failure. Patients were followed in an inner-city clinic before and after initiating a walk-in option in the clinic and a “fast-track” assessment clinic in the Harrisburg Hospital Emergency Department. Data collection included demographics, type of cardiac dysfunction, New York Heart Association classification, comorbidities and the use of cardio- protective medications and interventions. Data also included hospital readmissions within 30 days from hospital discharge for CHF exacerbations, specifically in the 9 months before and after the outpatient care facilities were opened. Results: Ninety-three patients with Congestive Heart Failure were enrolled (41 females, 52 males). Patients had comorbid conditions including hypertension (94%), diabetes (54%), Coronary Artery Disease (40%), atrial fibrillation (20%), asthma (17%), and COPD (30%). In the 93 patients, 17 patients (18.3%) had at least one 30-day readmission in the 9 months prior to outpatient care facility implementation, which decreased to 9 patients (9.7%) in the 9 following months, showing absolute improvement of 8.6% (p=0.0023). The total number of readmissions in the same 9-month periods decreased from 27 (0.29 per patient, SD=0.69) to 13 (0.14 per patient, SD=0.46), showing absolute improvement of 0.15 (p=0.0341). Conclusions: There was a significant decrease in 30-day readmissions for CHF exacerbations following the implementation of the walk-in clinic and “fast-track” outpatient care facilities. By illustrating the effectiveness of these facilities, we hope to inspire the initiation of similar outpatient care options and therefore decrease preventable readmissions and medical costs.

CONGESTIVE HEART FAILURE: OPENING DOORS OUTPATIENT TO PREVENT MANAGEMENT INPATIENT

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Page 1: CONGESTIVE HEART FAILURE: OPENING DOORS OUTPATIENT TO PREVENT MANAGEMENT INPATIENT

A558JACC April 1, 2014

Volume 63, Issue 12

Congenital Heart Disease

cOngestiVe heart failure: OPening DOOrs OutPatient tO PreVent management inPatient

Poster ContributionsHall CSunday, March 30, 2014, 9:45 a.m.-10:30 a.m.

Session Title: Heart Failure and Cardiomyopathies: Challenge of Acute Decompensated Heart FailureAbstract Category: 12. Heart Failure and Cardiomyopathies: ClinicalPresentation Number: 1186-200

Authors: Mrinalini Krishnan, Kamran Uddin, Leilani Garcia, Yijin Wert, Pramil Cheriyath, PinnacleHealth Hospital, Harrisburg, PA, USA

background: Congestive Heart Failure (CHF) is a chronic medical condition accounting for numerous hospital admissions for exacerbations each year. Hospitals have established various outpatient walk-in and “fast-track” clinics in hopes of preventing hospital readmissions. We hypothesized that implementing such alternative outpatient evaluation facilities would reduce 30-day readmissions for CHF exacerbations.

methods: A retrospective chart review was done of 93 patients with Congestive Heart Failure. Patients were followed in an inner-city clinic before and after initiating a walk-in option in the clinic and a “fast-track” assessment clinic in the Harrisburg Hospital Emergency Department.

Data collection included demographics, type of cardiac dysfunction, New York Heart Association classification, comorbidities and the use of cardio-protective medications and interventions. Data also included hospital readmissions within 30 days from hospital discharge for CHF exacerbations, specifically in the 9 months before and after the outpatient care facilities were opened.

results: Ninety-three patients with Congestive Heart Failure were enrolled (41 females, 52 males). Patients had comorbid conditions including hypertension (94%), diabetes (54%), Coronary Artery Disease (40%), atrial fibrillation (20%), asthma (17%), and COPD (30%). In the 93 patients, 17 patients (18.3%) had at least one 30-day readmission in the 9 months prior to outpatient care facility implementation, which decreased to 9 patients (9.7%) in the 9 following months, showing absolute improvement of 8.6% (p=0.0023). The total number of readmissions in the same 9-month periods decreased from 27 (0.29 per patient, SD=0.69) to 13 (0.14 per patient, SD=0.46), showing absolute improvement of 0.15 (p=0.0341).

conclusions: There was a significant decrease in 30-day readmissions for CHF exacerbations following the implementation of the walk-in clinic and “fast-track” outpatient care facilities. By illustrating the effectiveness of these facilities, we hope to inspire the initiation of similar outpatient care options and therefore decrease preventable readmissions and medical costs.