Projects per year
Abstract
Background: We identified variation in delivery of guideline recommended care at our institution, and undertook a project to design a heart failure (HF) model of care. Aim: To maximise time patients with HF spend well in the community by delivering best practice guidelines to reduce variation in care improving overall outcomes. Methods: This quality improvement project focused on reducing variation in process measures of care. The HF model of care included electronic HF care bundles, a patient education pack with staff training on delivering HF patient education, referral of all HF patients to the Hospital Admissions Risk Program for phone call within 72 h, and a nurse–pharmacist early follow-up clinic. Outcomes were assessed using interrupted time series analyses. Results: The pre-intervention group comprised 1585 patients, and post-intervention 1720 patients with a primary diagnosis of HF admitted under general cardiology and general medicine. Interrupted time series analysis indicated 30-day readmissions did not change in overall trend (−0.2% per month, P = 0.479) but a significant immediate step-down of 7.8% was seen (P = 0.018). For 90-day readmissions, a significant trend reduction over the time period was seen (−0.6% per month, P = 0.017) with a significant immediate step-down (−9.4%, P = 0.001). Emergency department representations, in-patient mortality and length of stay did not change significantly. Improvements in process measures were seen at audit. Conclusion: This model of care resulted in overall trends of reductions in 30- and 90-day readmissions, without increasing emergency department representations, mortality and length of stay. This model will be adapted as the electronic medical record is introduced at our institution.
Original language | English |
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Pages (from-to) | 557-564 |
Number of pages | 8 |
Journal | Internal Medicine Journal |
Volume | 51 |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2021 |
Keywords
- continuous quality improvement
- care bundle
- variation
- transitional care
- heart failure toolkit
Projects
- 2 Finished
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The STAREE Heart Study
Hopper, I. (Primary Chief Investigator (PCI)), Zoungas, S. (Associate Investigator (AI)), Kaye, D. (Associate Investigator (AI)), Reid, C. (Associate Investigator (AI)), McNeil, J. (Associate Investigator (AI)), Wang, B. (Associate Investigator (AI)), Freedman, B. (Associate Investigator (AI)), Marwick, T. H. (Associate Investigator (AI)) & Tonkin, A. (Associate Investigator (AI))
National Health and Medical Research Council (NHMRC) (Australia)
1/01/19 → 31/12/23
Project: Research
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Polypharmacy in elderly Australians - can deprescribing improve health related outcomes and reduce costs?
Hopper, I. (Primary Chief Investigator (PCI))
National Health and Medical Research Council (NHMRC) (Australia)
1/01/17 → 31/12/21
Project: Research