A Summative Program Evaluation of an Outpatient Community Heart Failure Clinic

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Tina Gray Carr (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Julia Kordsmeier

Abstract: Background: A southeastern US rural hospital supported by an outpatient heart failure (HF) clinic struggled with high readmission rates. Due to the high prevalence of HF, associated extreme costs, and readmission burden it was important to identify interventions to decrease hospital readmissions. Purpose: The purpose of this project was to evaluate effectiveness of a HF clinic program as a quality improvement initiative. The project also identified research recommendations for decreasing hospital HF readmissions related to outpatient HF clinics. Methods: A summative program evaluation was conducted through a quantitative retrospective design. Data from the HF clinic including age, sex, and race for the years 2017-2020 was collected and evaluated. Results: A total of 896 of the 3822 clinic visits examined represented patients readmitted to the hospital within 30 days from a previous HF admission. Readmission rates from the HF clinic increased each year with the exception of 2019. Females attend the clinic more often, however males were the majority of 30-day readmissions. Whites comprised 62% of the HF clinic visits as compared to African Americans at 37%. Additionally, African Americans were much younger than their white counterparts. Recommendations: A transition of care (TOC) clinic program with resources of a HF cardiologist, nursing staff, social worker, and pharmacist should be implemented to provide an outpatient setting safety net for patients.Conclusions: Clearly defined objectives are needed for the HF clinic program. Support in a HF TOC clinic can improve readmission rates, mortality, and financial stability for healthcare organizations.

Additional Information

Publication
Dissertation
Language: English
Date: 2022
Keywords
heart failure, congestive heart failure, readmissions, heart failure clinics, outpatient clinics, transitions of care, quality improvement, program evaluation

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