Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .
A comprehensive hospital-based intervention to reduce readmissions for chronically ill patients: a randomized controlled trial.
OBJECTIVES Medicare penalizes hospitals with 30-day readmissions above their expected rates . Hospitals have responded by implementing transitional care interventions ; however , there is limited evidence to inform the development of a successful intervention . STUDY DESIGN Parallel-group , stratified , r and omized controlled trial . METHODS A total of 512 patients hospitalized at 2 community hospitals , with congestive heart failure ( CHF ) or chronic obstructive pulmonary disease ( COPD ) , were r and omly assigned to the intervention ( n = 253 ) or usual care ( n = 259 ) . The intervention encompassed a 90-day hospital-based transitional care program . The primary end points were 30- and 90-day all-cause readmissions . Secondary measures included all-cause emergency department ( ED ) visits and mortality . RESULTS On average , study participants were 67 years of age , 57 % female , and 70 % insured by Medicare . There was no statistical difference between treatment groups on 30-day readmission incidence rates ( difference , 0.040 ; 95 % CI , -0.047 to 0.127 ; P = .36 ) , or 90-day readmission incidence rates ( difference of 0.035 ; 95 % CI -0.122 to 0.192 ; P = .66 ) . Groups also did not differ in ED visit incidence rates at 30 or 90 days . The mortality rate among patients with CHF showed no difference between groups ( risk ratio = 0.90 ; 95 % CI , 0.40 - 2.05 ) . However , for COPD , mortality at 90 days was lower in the intervention group than in the usual care group ( risk ratio = 0.28 ; 95 % CI , 0.10 - 0.83 ) . CONCLUSIONS St and -alone community hospitals may be unable to prevent readmissions despite the use of comprehensive , evidence -based intervention components that are within their control . Better collaboration between hospitals and community-based providers is needed to ensure continuity of care for discharged patients . TRIAL REGISTRATION Clinical Trials.gov , Identifier : NCT01855022
Main Findings : The results indicate that an intervention involving any human factor principles may nearly double an individual ’s probability of not being readmitted .
Principal Conclusions : Interventions with human factor principles reduce readmissions among HF patients .
Background : Human factors play an important role in health-care outcomes of heart failure ( HF ) patients .
A systematic review and meta- analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies .
Purpose : To investigate how the 8 guiding principles of choice , rest , environment , activity , trust , interpersonal relationships , outlook , and nutrition reduce HF readmissions .