Heart Failure Program Lowers Mortality Readmissions

Nurse Leader Insider, August 2, 2018

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Studies have shown that heart failure care—which cost an estimated $31.7 billion in 2012 and is projected to more than double by 2030—is a leading driver of healthcare costs in the United States.
But a new study finds that the University of Virginia Health System's Hospital-to-Home program has had success improving HF patient outcomes while saving money, and nurse practitioners play a key role in the program.
Improved Outcomes
The program, which is available to all HF patients living within 90 miles of the UVA Medical Center, provides patients with follow-up care for 30 days after hospital discharge. Participants can receive follow-up visits and other support from two NPs specializing in HF.
The study compared patients enrolled in H2H to those who did not participate in the program between January 2011 and December 2014. 

In the first 30 days after discharge, program participants had:
•    A 41% percent lower mortality rate than non-participants
•    A 24% reduction in the number of days where they were readmitted to the hospital
These improvements in outcomes occurred even though H2H participants were sicker than non-participants, the study found.
The cost savings from the program were estimated to be about twice as much as the program’s staffing costs.
NP Support
Within a week of being released from the hospital, patients typically have an in-person visit with one of the program’s NPs. Working with UVA physicians, pharmacists and other team members, the NPs assess patients’ heart failure symptoms and lab results, adjust their medications as needed and suggest lifestyle adjustments such as dietary changes.
“It’s important to have a program that follows patients closely and especially during their most vulnerable period following a discharge from the hospital. In this regard, a discharge from the hospital is not really a final goodbye, but rather just another phase of their care,” Sula Mazimba, MD, MPH, a study co-author and a heart failure specialist at UVA, says in a news release.

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