The Impact of Telephonic Follow-Up Within 2 Business Days Postdischarge on 30-Day Readmissions for Patients With Heart Failure

J Dr Nurs Pract. 2021 Jan 19:JDNP-D-19-00079. doi: 10.1891/JDNP-D-19-00079. Online ahead of print.

Abstract

Background: Heart failure (HF) is a chronic condition associated with high rates of hospital readmissions. The prevalence and costs of HF are expected to rise dramatically by 2030 (Heidenreich,et al., 2013).

Objective: A 24-month, retrospective study was conducted using electronic medical record (EMR) chart review, seeking to identify if postdischarge follow-up phone calls decreased 30-day readmissions in individuals with HF.

Methods: The study included 705 adult participants who were admitted to the hospital for HF. Some received a postdischarge call within 2 business days of discharge, and some did not.

Results: Participants who received the postdischarge call were less likely to be readmitted (20.1%) than participants who did not receive a postdischarge call (28.8%; p = .007). Participants who received the postdischarge call were more likely to have a follow-up visit within 14 days (70.1%) than participants who did not receive a postdischarge call (30.2%; p < .001).

Conclusions: The findings from this study may help to drive future transitional care strategies for individuals diagnosed with HF.

Implications for nursing: Nurse-led transitional care interventions offer potential solutions to ensure safe, effective hospital discharges.

Keywords: care coordination; care transitions; heart failure; readmissions.