title: Using Innovative Methodologies From Technology and Manufacturing Companies to Reduce Heart Failure Readmissions.
abstract: Heart failure (HF) patients have high 30-day readmission rates with high costs and poor quality of life. This study investigated the impact of a framework blending Lean Sigma, design thinking, and Lean Startup on 30-day all-cause readmissions among HF patients. This was a prospective study in an academic hospital in Baltimore, Maryland. Thirty-day all-cause readmission was assessed using the hospital's electronic medical record. The baseline readmission rate for HF was 28.4% in 2010 with 690 discharges. The framework was developed and interventions implemented in the second half of 2011. The impact of the interventions was evaluated through 2012. The rate declined to 18.9% among 703 discharges (P < .01). There was no significant change for non-HF readmissions. This study concluded that methodologies from technology and manufacturing companies can reduce 30-day readmissions in HF, demonstrating the potential of this innovations framework to improve chronic disease care.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Amber E
authors.initials: AE
authors.lastname: Johnson
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Baltimore, MD.
authors.forename: Laura
authors.initials: L
authors.lastname: Winner
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Tanya
authors.initials: T
authors.lastname: Simmons
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Shaker M
authors.initials: SM
authors.lastname: Eid
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Baltimore, MD.
authors.forename: Robert
authors.initials: R
authors.lastname: Hody
authors.affiliation: Johns Hopkins Bayview Medical Center, Baltimore, MD.
authors.forename: Angel
authors.initials: A
authors.lastname: Sampedro
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Sharon
authors.initials: S
authors.lastname: Augustine
authors.affiliation: Johns Hopkins Bayview Medical Center, Baltimore, MD.
authors.forename: Carol
authors.initials: C
authors.lastname: Sylvester
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD Kapil.parahk@gmail.com.
authors.forename: Kapil
authors.initials: K
authors.lastname: Parakh
mesh_terms: D000368:Aged; D057286:Electronic Health Records; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010353:Patient Education as Topic; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D058996:Quality Improvement; D012307:Risk Factors
keywords: Lean Sigma; heart failure; multidisciplinary; quality improvement; readmissions