Congestive heart failure is one of the top three reasons for hospital readmissions in northeast Indiana, according to the local Care Coordination Community there. Dupont Hospital in Fort Wayne collaborated on a congestive heart failure pilot project with a skilled nursing facility (SNF) and a home health agency (HHA).
“The methods we implemented with this pilot were a great reminder of the purpose of discharge planning and that we need to consider disease-specific concepts when assessing for discharge needs,” said Marcia Kessler, a registered nurse and team specialist for Dupont Hospital.
The rate of patients being readmitted into the hospital with heart failure was lowered from 18.2 percent to 6.1 percent. During the six-month pilot project, 155 high-risk patients diagnosed with heart failure were guided through the congestive heart failure pathway and only eight were readmitted to the hospital.
atom Alliance estimates that this project prevented 20 patients from being readmitted and saved the Medicare health system approximately $175,260.