title: Implementation of a heart failure readmission reduction program: a role for medical residents.
abstract: BACKGROUND
  Congestive heart failure (CHF) is one of the leading causes of hospital readmissions within 30 days of discharge. Due to the substantial costs associated with these readmissions, several interventions to reduce CHF readmissions have been developed and implemented.
  
  
  METHODS
  To reduce CHF readmissions at our community teaching hospital, the Smooth Transitions Equal Less Readmission (STELR) program was developed. Utilizing the Plan-Do-Check-Act cycle for quality improvement, resident physicians tracked patients enrolled in the STELR program. The resident contribution to the program was substantial in that they were able to quantify the improvement in both physician practices and patient readmissions. This provided insight into program areas requiring further modification, which the hospital would not have obtained without resident participation.
  
  
  RESULTS
  The readmission rate for patients diagnosed with heart failure decreased from 32% prior to program implementation, to 24% hospital wide (including patients who were not tracked in the STELR program), and 21% among patients tracked by the residents.
  
  
  CONCLUSIONS
  This effective CHF readmission reduction program requires less financial resources compared to government funded programs. The resident involvement in the STELR program helped to assess and improve the program and also allowed the residents to gain an awareness of the resources available to their patients to facilitate their transition home. The program exposed the residents to systems-based practice, a fundamental element of their residency training and, more generally, community care.
authors.affiliation: Department of Internal Medicine, Lutheran Medical Center, Brooklyn, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rabbat
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Bashari
authors.forename: Rajnish
authors.initials: R
authors.lastname: Khillan
authors.forename: Manisha
authors.initials: M
authors.lastname: Rai
authors.forename: Jose
authors.initials: J
authors.lastname: Villamil
authors.forename: Julie M
authors.initials: JM
authors.lastname: Pearson
authors.forename: Archana
authors.initials: A
authors.lastname: Saxena
keywords: Heart failure; documentation; hospital readmission; medical residency; quality improvement; systems-based practice