Volume 13 Supplement 3
Decrease in the 30-day heart failure (HF) Rehospitalization Rate after the implementation of a HF managed protocol
© BioMed Central Ltd 2009
Published: 23 June 2009
Heart failure (HF) is associated with high morbidity and mortality rates, including frequent rehospitalization. The 30-day HF Rehospitalization Rate is an outcome quality indicator used to measure the quality of care.
To identify changes in the 30-day HF Rehospitalization Rate after the implementation of a HF managed protocol.
A cross-sectional prospective study of 671 patients hospitalized for heart failure in a tertiary private Brazilian hospital. Patients were divided into two groups: 189 patients admitted in the pre-protocol period (January 2005 to July 2006) and 452 patients admitted in the post-protocol period (August 2006 to May 2008). Mean age was 75.0 ± 12.0 years (range: 21 to 102 years). The HF protocol was implemented on 1 August 2006 and consisted of a written protocol, on-time data collection for quality indicators, and periodic performance feedback (reports) given to the clinical and administrative staff. Data collection before the protocol implementation was done retrospectively by a nurse case-manager. Statistical analysis was performed using the chi-square test, Student's t test and Fisher's exact test. P < 0.05 was considered statistically significant.
Age (years), mean ± SD
76.9 ± 10.2
75.0 ± 12.0
Ejection fraction (%), mean ± SD
31.0 ± 7.67
31.9 ± 7.6
Admitted in cardiogenic shock (%)
β-Blocker use (%)
ACEI/ARB use (%)
Spironolactone use (%)
Smoking cessation counseling rate (%)
30-day HF Rehospitalization Rate
In the present study, the implementation of a HF managed protocol led to a significant decrease in the 30-day HF Rehospitalization Rate along with an increase in the prescription rate of evidence-based therapies, even though the rate of patients admitted in cardiogenic shock was higher.