Title

Root Cause Analysis Heart Failure Readmissions at Thomas Jefferson University Hospital

Document Type

Presentation

Publication Date

12-2012

Comments

Advisor: James Plumb, MD, MPH, Jefferson Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.

Abstract

Under the Patient Protection and Affordable Care Act, the Centers for Medicare and Medicaid Services established significant financial penalties for hospitals that do not meet certain benchmarks for decreased readmission rates. Heart failure patients account for more readmissions in US hospitals than any other illness. While the rates of heart failure readmission are well-established, the patient perspectives behind these increased visits remain unclear. The purpose of this study is to identify the root causes for high hospital readmission rates for heart failure patients at Thomas Jefferson University Hospital (TJUH) in Philadelphia. Additionally, goals include assessing health status of recently readmitted patients and obtaining patient-perceived reasons behind hospital readmissions. These reasons are considered in the context of current programs that aim to decrease readmission rates. Individual patient interviews and a validated survey tool were conducted with twelve patients readmitted to TJUH within 30-days over a period from April 2012 to August 2012. The survey results were calculated quantitatively and the interviews were coded into common themes for qualitative analysis. Results identified several factors influencing readmission rates: missed follow-up appointments, medication non-compliance, dietary non-compliance, lack of education on health management, and lack of family or community support. Based on the findings, each step or change in medication management should be thoroughly outlined to the patient, as well as increased efforts by hospital staff to provide a sample meal plan for dietary restrictions. Furthermore, psychological counseling should be offered while in the hospital to any patient suffering from heart failure. The results of this study support a need for improved continuity of care between services provided at the hospital and those maintained through home health services (i.e. Jefferson Home Care).

Presentation: 27 minutes