title: Utilization of trained volunteers decreases 30-day readmissions for heart failure.
abstract: BACKGROUND
  This study evaluated the effectiveness of using trained volunteer staff in reducing 30-day readmissions of congestive heart failure (CHF) patients.
  
  
  METHODS
  From June 2010 to December 2010, 137 patients (mean age 73 years) hospitalized for CHF were randomly assigned to either: an interventional arm (arm A) receiving dietary and pharmacologic education by a trained volunteer, follow-up telephone calls within 48 hours, and a month of weekly calls; or a control arm (arm B) receiving standard care. Primary outcomes were 30-day readmission rates for CHF and worsening New York Heart Association (NYHA) functional classification; composite and all-cause mortality were secondary outcomes.
  
  
  RESULTS
  Arm A patients had decreased 30-day readmissions (7% vs 19%; P < .05) with a relative risk reduction (RRR) of 63% and an absolute risk reduction (ARR) of 12%. The composite outcome of 30-day readmission, worsening NYHA functional class, and death was decreased in the arm A (24% vs 49%; P < .05; RRR 51%, ARR 25%). Standard-care treatment and hypertension, age ≥65 years and hypertension, and cigarette smoking were predictors of increased risk for readmissions, worsening NYHA functional class, and all-cause mortality, respectively, in the multivariable analysis.
  
  
  CONCLUSIONS
  Utilizing trained volunteer staff to improve patient education and engagement might be an efficient and low-cost intervention to reduce CHF readmissions.
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Virna L
authors: VL
authors: Sales
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Muhammad Salman
authors: MS
authors: Ashraf
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Leela K
authors: LK
authors: Lella
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Jiaxin
authors: J
authors: Huang
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Geetha
authors: G
authors: Bhumireddy
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Lance
authors: L
authors: Lefkowitz
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Mimi
authors: M
authors: Feinstein
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Mikail
authors: M
authors: Kamal
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Raqib
authors: R
authors: Caesar
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Elizabeth
authors: E
authors: Cusick
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Jane
authors: J
authors: Norenberg
authors: Volunteer and Educational Resources Department, New York Methodist Hospital, Brooklyn, New York.
authors: Jiwon
authors: J
authors: Lee
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Sorin
authors: S
authors: Brener
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York.
authors: Terrence J
authors: TJ
authors: Sacchi
authors: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York. Electronic address: jfh9003@nyp.org.
authors: John F
authors: JF
authors: Heitner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006758:Hospital Volunteers / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods / Q000639:trends*; D010359:Patient Readmission / Q000639:trends*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Community patients; patient education; patient-centered intervention; risk factors