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; ora 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.affiliation: Division of Cardiology, New York Methodist Hospital, Brooklyn, New York
authors.forename: Virna L
authors.initials: VL
authors.lastname: Sales
authors.forename: Muhammad Salman
authors.initials: MS
authors.lastname: Ashraf
authors.forename: Leela K
authors.initials: LK
authors.lastname: Lella
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Huang
authors.forename: Geetha
authors.initials: G
authors.lastname: Bhumireddy
authors.forename: Lance
authors.initials: L
authors.lastname: Lefkowitz
authors.forename: Mimi
authors.initials: M
authors.lastname: Feinstein
authors.forename: Mikail
authors.initials: M
authors.lastname: Kamal
authors.forename: Raqib
authors.initials: R
authors.lastname: Caesar
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cusick
authors.forename: Jane
authors.initials: J
authors.lastname: Norenberg
authors.forename: Jiwon
authors.initials: J
authors.lastname: Lee
authors.forename: Sorin
authors.initials: S
authors.lastname: Brener
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Sacchi
authors.forename: John F
authors.initials: JF
authors.lastname: Heitner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061345:Early Medical Intervention / Q000379:methods / Q000639:trends*; D004493:Education / Q000379:methods / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000639:trends*; D011446:Prospective Studies; D013997:Time Factors; D014838:Volunteers / Q000193:education*