AMGA announced that participants in its Best Practices in Managing Patients with Heart Failure Collaborative, supported by Novartis Pharmaceuticals Corporation, collectively lowered their all-cause readmission rate for their heart failure patients. Consolidated data from the participating organizations showed that the percentage of heart failure patients who were readmitted within 30 days for any cause decreased from 27% just prior to the collaborative to 15% by the end of the collaborative, compared to the national average of 21.6%.

Heart failure is a chronic disease that affects 5.1 million people in the United States. It’s the leading cause of hospitalization among adults 65 and older, and costs are estimated at $32 billion a year.

“Although there have been improvements in outcomes, admission rates following heart failure hospitalization remain high, with more than 50% of patients readmitted to the hospital within six months of discharge,” said Jerry Penso, MD, president and chief executive officer, AMGA, and president of AMGA Foundation. “Fifteen AMGA members committed to come together in a national forum to share best practices to improve care for patients with heart failure. And they succeeded. We congratulate them and are pleased to share their learnings through published case studies.”

The Best Practices in Managing Patients with Heart Failure Collaborative was facilitated by AMGA Foundation, the association’s nonprofit arm. The collaborative involved 15 AMGA member organizations and more than 16,000 patients. It commenced in November 2015 and concluded in December 2016. In addition to achievements in reducing readmissions, some of the participating organizations improved processes to ensure patients were being prescribed the specific beta-blockers identified in best practices.

The particular interventions can be found in the Best Practices in Managing Patients with Heart Failure Compendium. The compendium includes case studies from medical groups, academic practices, and integrated delivery systems that have incorporated the management of heart failure into their chronic care models. The case studies outline some of the following interventions that the participating organizations implemented in their care models:

• Establishment of an intravenous diuresis clinic, use of space in an existing clinic for intravenous diuresis, and development of an intravenous lasix protocol for long-term fluid management in the home
• New technology to monitor patient’s fluid status after discharge
• Palliative care services to help patients and their caregivers deal with the challenges of living with heart failure
• Collaboration with the skilled nursing facilities (SNFs) in the community which received patients with chronic heart failure after hospital discharge; education and training provided to the SNF staff on mutually agreed-upon care for the patient