EVALUATION OF 30-DAY READMISSION RATES AND DISCHARGE MEDICATION MANAGEMENT IN HEART FAILURE AND NON-ST-ELEVATION MYOCARDIAL INFARCTION

Atrium

Objective. The purpose of this investigation is to evaluate the care provided to heart failure (HF) and non-STelevation myocardial infarction (NSTEMI) patients by a group of hospitalists at a large academic affiliated tertiary care center, and relation to 30-day readmissions. Background. HF and NSTEMI diagnoses are two of the most common causes of hospitalization and readmissions. Reimbursement is tied to management according to guidelines established for these disease states, and also to readmission rates. Methods. Four hospitalist services managing HF and NSTEMI patients were retrospectively evaluated April 2013 to June 2013. Discharge medications, insurance, readmissions, and length of stay were gathered to evaluate quality of care. A scoring system validated at another academic medical center was used to investigate readmission rates and whether a similar relationship existed. All institutional review board procedures were followed. Results. Thirty-five HF and thirty-five NSTEMI diagnoses were identified. 77% of HF patients received guideline directed therapy (GDT) and 14% were readmitted within 30 days. GDT was provided to 43% of the NSTEMI group, no readmissions identified. Appropriate documentation was found in 64% of HF diagnoses and 60% of the NSTEMI diagnoses. No relationship was identified regarding the scoring system and 30-day readmissions for this study. Conclusion. Most patients received GDT upon discharge. Initiatives for standardization of documentation, investigation with a larger sample size and a longer time period are areas of opportunity. Development of a validated hospital-specific tool would be valuable. Continual involvement of pharmacy students in such initiatives may be beneficial. Grants. None