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• W1981903679 abstract "Heart failure (HF) readmissions have been associated with increased mortality, morbidity, and cost. However, relatively few studies have focused on provider education as a potential mechanism to reduce HF readmissions. HF education and use of a Heart Failure Admission Navigator (HFAN) tool by providers will improve provider knowledge, discharge process measures, and readmission or mortality for HF patients. Internal medicine residents on four inpatient cardiology teams at a single teaching institution were prospectively randomized in a one to one fashion to intervention and control arms, both of which completed a HF knowledge assessment (max score = 21) at the beginning and end of the four week rotation. Intervention included 1) a brief, single session review of best practices for HF treatment and 2) placement of a HFAN tool in the chart for completion on all HF patients. Control included usual inpatient HF care. Data were analyzed by Wilcoxon Rank-Sum and t test to determine if provider knowledge improved. We also analyzed HF readmissions or death, discharge medications, and discharge process measures by intention to treat and per protocol analysis using Kaplan-Meier, t test, Fisher’s exact test, and Kruskal-Wallis tests. Provider knowledge of HF best practices was significantly improved in the intervention arm compared with control for both general HF treatment (8 vs 1, p<.001) and HFSA discharge guidelines (5 vs 1, p<.001). In addition, there was a trend towards fewer patients with reduction of beta blocker (24% vs 34%, p=0.20) and ACE/ARB (18% vs 27%, p=0.17) dosing associated with the hospitalization in the intervention arm. The post-discharge follow up time was significantly shorter in the invention arm (6 vs 8 days, p=0.015). Patient 30-day readmission and death was not significantly different between arms. Provider education utilizing a simple checklist of HF best practices and institution specific resources (HFAN) resulted in a significant improvement in provider knowledge of HFSA discharge guidelines. HF medication dosing and discharge process measures were also improved in this small cohort of patients. Further study is required to determine if this tool could have a meaningful impact on 30-day HF readmissions." @default.
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• W1981903679 date "2014-08-01" @default.
• W1981903679 modified "2023-10-17" @default.
• W1981903679 title "A Simple Provider Education Tool Improves Heart Failure Knowledge and Discharge Process Measures" @default.
• W1981903679 doi "https://doi.org/10.1016/j.cardfail.2014.06.326" @default.
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