Heart disease is one of the central concerns of the modern healthcare sector. For instance, congestive heart failure (CHF) is one of the leading health conditions with high incidences of 30-day readmission rates, constituting 30% of all readmission incidences (Nair et al., 2020). CHF is a chronic medical condition that affects about six million individuals in the United States every year, creating a financial burden in healthcare amounting to over 30 billion USD (Nair et al., 2020). The disease also presents relatively high mortality rates in which 30-40% of the surviving cases up to 12 months after being hospitalized (Inamdar & Inamdar, 2016). The high rates of readmissions cause great pain to the patients and their families besides being a burden to the healthcare.
Today, there are numerous attempts to manage the problem and attain improved outcomes. To decrease the incidences of readmissions, the center of Medicare and medical services (CMS) introduced the Hospital Readmission Reduction Program (HRRP) in 2012 (Inamdar & Inamdar, 2016). The program intends to minimize the number of readmission incidences for individuals admitted for heart failure. Nevertheless, the number of cases of CHF readmissions remains relatively high. Evidence has indicated that some interventions are crucial in promoting post-discharge development and reduce CHF rates. Unfortunately, regardless of these methods, CHF readmissions remain a challenge for the healthcare sector (Nair et al., 2020). Basic interventions such as enhancing the idea of lifestyle management and promoting medication adherence are crucial. Also, the ancillary staff should coordinate the patient follow-up appointments, especially before discharge, and this has reduced levels of readmission by 50% (Ziaeian & Fonarow, 2016). Patient education should be regarded as an integral procedure for the reduction of hospital readmissions. Each meeting with patients should be coupled with targeted education and assessment. Some specific questions should be taken into consideration during the interactions with patients, such as adherence to drugs, diet, and water consumption (Nair et al., 2020). It will help to attain enhanced results and provide patients with additional knowledge.
Another crucial intervention entails elaborate follow-ups with cardiologists within one week after being hospitalized for CHF, which can significantly lower the 30-day readmission incidences (Lee et al., 2016). Hospitals should ensure that increasing the number of nursing staff is important in addressing the challenge of readmissions. Taking measures to optimize medical therapy is essential to improve clinical outcomes and minimize hospitalizations and rehospitalization’s for the patient with CHF. Although it is critical to put in place measures to reduce the 30-day readmission prevalence for CHF patients (Nair et al., 2017).) Palazzuoli et al. (2019) state that early readmissions after discharge from the hospital indicate the treatment that was received was not well coordinated and was also incomplete. Clinicians should target to undertake stabilization and decongestion of fluid balance on oral diuretics, titration of neurohormonal antagonist for sustainable positive outcomes.
Optimization of relevant therapies such as angiotensin receptor blockers, angiotensin-converting enzyme inhibitors reduces rehospitalization. During this phase, their little effective remedies for individuals experiencing pervasive heat failure. For significant benefits to be observed, early interventions must be undertaken. It is essential to remain watchful to prevent decompensation since most social factors and patient factors may lead to destabilization of the fluid balance that had occurred during hospitalization (Westphal et al., 2018). Evidence has indicated that many cases of HF readmissions arise due to the development of cardiac filling pressures, and therefore, efficient HF management should involve a kind of prolonged monitoring to sport any symptoms for congestion early enough. However, clinicians have experienced challenges in identifying the early signs for tracking because clinical signs are not conclusive in determining early decompensation, nor have they shown a comprehensive manifestation to allow early intervention to avoid hospitalization (Palazzuoli et al., 2019). Appropriate therapy to address the physiological signal of the pulmonary artery pressures was linked to 40% lower cases of heart failure hospitalizations (Inamdar, A., & Inamdar, A. (2016). It can be considered a promising intervention to address the issue.
Prediction of readmissions is another vital element of healthcare today. It helps to determine the at-risk populations and compare outcomes among different hospitals (Ziaeian & Fonarow, 2016). Various relevant models can be utilized to predict readmissions though such models have portrayed inconsistent results. Aldosterone inhibitors have been found in clinical trials to lower hospitalizations and mortality, with positive outcomes being experienced 30 days after the start of therapy (Westphal et al., 2018). Device therapies like implantable cardiofilators have been found to potentially decrease the incidences of sudden cardiac death. Cardiac resynchronization therapies have been found to decreased clinical signs for HF and promote left ventricular functions. For instance, in a study, cardiac resynchronization portrayed a 15% reis reduction in heart failure readmissions in which there was an average follow-up of 30 months (Upadhyay et al., 2019). Scholars are now considering the potential for utilizing new technologies for monitoring congestion as a measure of reducing readmissions is a developing endeavor (Ziaeian & Fonarow, 2016). Using these innovations, it is possible to reduce incidence rates and attain better results.
In conclusion, identifying appropriate healthcare approaches that are evidence-based to lower the incidence of preventable hospitalization for heart failure would be bifacial to the patients, clinicians, and healthcare systems. Utilization of preventive education, medication reconciliation, and discharge planning, compressive follow-up procedures before discharge should be installed to reduce the grates of readmissions. In general, more comprehensive interventions give rise to better clinical outcomes. Their indicator shows that high-quality patient care has not been achieved in hospitals, and therefore relatively high rates of readmissions continue to experience.
Inamdar, A., & Inamdar, A. (2016). Heart Failure: Diagnosis, management and utilization. Journal of Clinical Medicine, 5(7), 62. Web.
Lee, K. K., Yang, J., Hernandez, A. F., Steimle, A. E., & Go, A. S. (2016). Post-discharge follow-up characteristics associated with 30-day readmission after heart failure hospitalization. Medical Care, 54(4), 365-372. Web.
Nair, R., Lak, H., Hasan, S., Gunasekaran, D., Babar, A., & Gopalakrishna, K. V. (2020). Reducing all-cause 30-day hospital readmissions for patients presenting with acute heart failure exacerbations: A quality improvement initiative. Cureus, 12(3). Web.
Palazzuoli, A., Evangelista, I., Ruocco, G., Lombardi, C., Giovannini, V., & Nuti, R. et al. (2019). Early readmission for heart failure: An avoidable or ineluctable debacle? International Journal of Cardiology, 277, 186-195. Web.
Upadhyay, G., Vijayaraman, P., Nayak, H., Verma, N., Dandamudi, G., & Sharma, P. et al. (2019). His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure. Journal of The American College of Cardiology, 74(1), 157-159. Web.
Westphal, J. G., Bekfani, T., & Schulze, P. C. (2018). What’s new in heart failure therapy 2018? Interactive Cardiovascular and Thoracic Surgery, 27(6), 921-930. Web.
Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in Cardiovascular Diseases, 58(4), 379-385. Web.