Introduction
Congestive heart failure (CHF) afflicts more than 5 million people in the United States (Garcia & Bradford, 2017). Advancements in health research have availed different CHF therapies. However, the incidence and prevalence of the disorder continue to trouble the healthcare system as indicated by increased hospitalizations and healthcare spending. This paper provides a review of the literature on strategies used to reduce readmission rates among patients with congestive heart failure.
Review of Literature
Garcia and Bradford (2017) suggest the use of a strategic, well-defined home telehealth in lowering the cost of treatment associated with CHF as well as hospital readmission rates. The proposed system also shortens the length of hospital stays when undergoing CHF treatment. CARDIOCOM, which is a progressive telehealth monitoring program was used to keep an eye on CHF patients over a 30-day period. The purpose of the program was to back the patients’ treatment scheme by using technology to gather data, monitor patients and assess patients’ risk.
The inception of the program led to a significant reduction in 30-day hospital readmissions since the program was introduced in 2007. In a similar study, Messina (2016) describes the execution of a home telehealth program meant to enhance communication among CHF patients, medical providers, and administrative staff to lower readmission rates for CHF patients receiving care at a hospital in Tampa, Florida. Messina (2016) noted that the telehealth system reduced hospital readmission rates by about 5%. Patients reported improved satisfaction as well as a reduction in treatment costs. A comparison of these two studies indicates that the effective management of CHF patients requires providers to consider innovative methods of providing post-hospital care.
In a separate study, Wiskar, Celi, Walley, Fruhstorpher, and Rush (2017) endorse the provision of palliative care for patients with advanced CHF. This recommendation is based on the success of palliative care in reducing hospital readmission rates in other health complications. It was noted that providing palliative care during inpatient visits reduced the odds of readmission for heart failure and other health complications during a nine-month follow-up period.
Prompt identification of a heart failure incident plays a vital role in averting readmission (Kanat & Nichols, 2017). One useful indicator of heart failure is pulmonary artery pressure, which is a more accurate reflection of volume status alterations in CHF patients than conventional techniques of weight monitoring and physical evaluation. It has also been noted that alterations in volume status manifest between one to three weeks before weigh changes or CHF symptom are evident.
Consequently, monitoring changes in volume status can help providers to anticipate and avert CHF incidents and readmissions. Kanat and Nichols (2017) tested a device known as CardioMEMS, which is a permanently implantable instrument that is capable of sensing changes in pulmonary arterial pressure. This gadget conveys pulmonary artery pressure readings from the patient’s home to a website accessible to the healthcare providers and provides substantial data to facilitate the management of CHF. Patients implanted with the device reported better health outcomes and reduced hospitalization rates (Kanat & Nichols, 2017).
Conventional methods of managing CHF incorporate diet, exercise and pharmacological interventions (Azad & Lemay, 2014). However, cases of CHF hospitalizations have been on the rise despite providers emphasizing the value of these interventions. Nevertheless, this observation does not mean that the mentioned intermediations are ineffective at lowering CHF-related hospitalizations. The reviewed studies do not mention whether or not other measures of managing CHF (such as diet, exercise, drugs) were used alongside the proposed technological interventions. It would be pertinent to develop a holistic, all-inclusive strategy to manage CHF effectively and lower the rate of CHF hospitalizations.
Conclusion
It is evident that the successful reduction of CHF readmission rates requires continuous monitoring of patients during hospitalization as well as following discharge. The use of technological advancements provides effective ways of keeping an eye on CHF patients post-discharge. Some of the tried and tested approaches include telehealth programs and implants. Therefore, there is a need to include technological methods in the conventional prevention strategies that focus on diet, exercise, and pharmacological interventions.
References
Azad, N., & Lemay, G. (2014). Management of chronic heart failure in the older population. Journal of Geriatric Cardiology: JGC, 11(4), 329-337.
Garcia, M. M., & Bradford, M. (2017). Improving CHF re-admission rates through CARDIOCOM telehealth program. Heart & Lung: The Journal of Acute and Critical Care, 46(3), 211-214.
Kanat, N., & Nichols, M. (2017). CardioMEMS for effective management of heart failure: Reducing healthcare utilization and 30-day readmissions. Heart & Lung: The Journal of Acute and Critical Care, 46(3), 213-214.
Messina, W. (2016). Decreasing congestive heart failure readmission rates within 30 days at the Tampa VA. Nursing Administration Quarterly, 40(2), 146-152.
Wiskar, K., Celi, L. A., Walley, K. R., Fruhstorpher, C., & Rush, B. (2017). Inpatient palliative care referral and 9‐month hospital readmission in patients with congestive heart failure: A linked nationwide analysis. Journal of Internal Medicine, 282(5), 445-451.