Utilization of trained volunteers decreases 30-day readmissions for heart failure

J Card Fail. 2014 May;20(5):377.e15-23.

Abstract

Background: This study evaluated the effectiveness of using trained volunteer staff in reducing 30-day readmissions of congestive heart failure (CHF) patients.Methods: From June 2010 to December 2010, 137 patients (mean age 73 years) hospitalized for CHF were randomly assigned to either: an interventional arm (arm A) receiving dietary and pharmacologic education by a trained volunteer, follow-up telephone calls within 48 hours, and a month of weekly calls; ora control arm (arm B) receiving standard care. Primary outcomes were 30-day readmission rates for CHF and worsening New York Heart Association (NYHA) functional classification; composite and all-cause mortality were secondary outcomes.Results: Arm A patients had decreased 30-day readmissions (7% vs 19%; P ! .05) with a relative risk reduction (RRR) of 63% and an absolute risk reduction (ARR) of 12%. The composite outcome of 30-day readmission, worsening NYHA functional class, and death was decreased in the arm A (24% vs 49%;P ! .05; RRR 51%, ARR 25%). Standard-care treatment and hypertension, age $65 years and hypertension,and cigarette smoking were predictors of increased risk for readmissions, worsening NYHA functional class, and all-cause mortality, respectively, in the multivariable analysis.Conclusions: Utilizing trained volunteer staff to improve patient education and engagement might be an efficient and low-cost intervention to reduce CHF readmissions.

Publication types

  • Corrected and Republished Article
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Early Medical Intervention / methods
  • Early Medical Intervention / trends*
  • Education / methods
  • Education / trends
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology*
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission / trends*
  • Prospective Studies
  • Time Factors
  • Volunteers / education*