The document outlines a quality improvement project to educate patients with heart failure on self-care techniques in order to reduce hospital readmission rates. It notes that heart failure is a common cause of hospitalization for those over age 65 and that providing discharge education and telephone follow-ups can help patients gain knowledge to better manage their condition through improved self-care. The goal of the intervention is to empower patients with knowledge and skills to better comply with treatment and reduce risks of readmission.

1. EDUCATE THE PATIENTS
WITH HEART FAILURE TO
REDUCE THE
READMISSION RATE
Emiliy Moore, Calle Lindén, The Dinh Thi

2. Task
 Key finding of QI summarized for the funder of
your project

3. Background
 20% among those 70-80 years in the western
world have heart failure.
 (Rosamond et al., 2008)
 Heart failure is the most common reason for
hospitalization in Sweden for people over the
age of 65
 (Swedish National Board of Health and Welfare
(Socialstyrelsen), 2008).

4. Our typical patient we want to
help
 Patient
 65-85 years
 Heart failure, NYHA Class I-III
 Living at home or at a home for elderly peoples
 Slightly decreased memory and understanding
 Risk of going back to hospital
Reduced
Knowledge Self-care risk för
readmission

5. Why educate?
Reduced risk of readmission
More knowledge
Better compliance
about their
to self-care
condition
Improved mental
Improved physical
health and quality
health
of life

6. Quality issue
Reduce the readmission rate
among patients with heart failure.
Measure the readmission rate
Educate and give the patient
knowledge to better be able to
perform self-care

7. • Make a new PDSA • Quality issuses among
cycle according to patients with heart
the data we failure. What do we need
receive from to know about our
measurments patients and also which
theories. How can we
improve the situation
ACT PLAN
STUDY DO
• Describe our • Improve the self-
measured results care through
discharge
education and
telephone follow
up along with web-
based services

8. Intervention
Web-
Discharge Telephone
based
education follow up
services

9. Leadership
1. Leadership
Setting and reaching collective goals, and to
empower individuals autonomy and
accountability
• Ask -- raise the issue
• Advise -- increase awareness of risk and
benefits related to behaviour
• Assist -- help the patient to identify a negotiated
SMART
(specific, measurable, achievable, realistic, time
d) goal related to behaviour change and
signpost if appropriate.

10. Measurments
 Make two groups with the same kind of
patients, one receiving the intervention one is
not,
 Count each time a patient in the study
achieves one of the possibilities
Effect Intervention Control g Reductio (P-value and or
g n CI)
 Using statistical tools like the chi-square to see
Possiblity 1 x (n) y (n) % value
if the the outcome is significant
Possiblity 2
Possiblity 3
Possiblity 4
Possibilty 5

11. Example of measure
 Patients who readmit to the ward
 n=100; 50 in each group
Effect Intervention Control Reduction
group group
No readmission 20 10 50%
One or more 10 20 -50%
readmission
Two or more 10 10 -
readmission
Readmission but 5 5 -
because of something
else
Died 5 5 -

12. Ethical consideration
 This is a very cost effective way to reduce the
readmission rate among this group of patients
 The education most be performed at a first
class level to meet the demands of the global
society needs.
 Nurses educating the patients are required to
have a deep understanding and exceptional
knowledge about heart failure and self-care.

13. Education and readmission
Author, year Outcome 1 Outcome 2
Koelling, Johnson, Cody Fewer days in hospital Reduced risk of
& Aaronson, 2005 readmission
Krumholz, Amatruda, Reduced risk of Fewer days in hospital
Smith, Mattera, readmission
Roumanis, Radford,
Crombie & Vaccarino,
2002
Kwok, Lee, Woo, Lee & Reduced risk of
Griffith, 2008 readmission
Domingues, Clausell , Reduced number of
Aliti, Dominguez & visits to the emergency
Rabelo, 2011 room

14. What do we need to begin the
project
Access to
databases
including but not Funding, 10000
limited to euro before 15/5
patients journal
and work
schedule
Soon™, when it’s
ready, contacts with
healthcare leaders in
the community

15. References
 Albert, N., Collier, S., Sumodi, V., Wilkinson, S., Hammel J.,Vopat, L. et al. (2002).
Nurses’ knowledge of heart failure education principles. Heart & Lung: The Journal of
Acute and Critical Care, 31,(2), 102-112.
 Hart, P., Spiva, L., Kimble, K. (2011). Nurses’ knowledge of heart failure education
principles survey: a psychometric study, Journal of Clinical Nursing, 20, 3020–3028.
 Lesman-Leegte, I., Jaarsma, T., Coyne, J., Hillege, H., Van Veldhuisen, D.,
Sanderman, R. (2008). Quality of life and depressive symptoms in the elderly: a
comparison between patients with heart failure and age- and gender-matched
community. Journal Of Cardiac Failure, 15(1), 17-23.
 New York Heart Association Functional Classification, 2009
 Rosamond, W., Flegal K., Furie K., Go, A., Greenlund K., Haase, N. et al. (2008).
Heart disease and stroke statistics--2008 update: a report from the American Heart
Association Statistics Committee and Stroke Statistics Subcommittee. Circulation
117, 125–146.
 Socialstyrelsen. (2008). Nationella Riktlinjer för hjärtsjukvård 2008. Stockholm:
Socialdepartementet.
 Strömberg, A. (2005). The crucial role of patient education in heart failure. The
European Journal of Heart Failure, 7, 363–369