A Need for Managed Care: Readmission Reduction in Heart Failure Patients Essay Example

for effective interventions, and de?cits in quality improvement capabilities among some organizations.” Understanding the reasons for a particular readmission and finding appropriate and sometimes innovative ways to improve transitional care is an essential component in readmission reduction goals. This can be especially daunting within the HF healthcare setting due to compliance issues. The task for ensuring treatment compliance was noted by Ivn Montoya that “treatment compliance may be influenced by factors associated with the therapist's characteristics, the service, the nature of the treatment and the patient's idiosyncrasies. (Montoya, 2006)” He went on to say that “a treatment that may involve a complex procedure, is hard to follow, has unpleasant side effects, take a while to produce the desired effect, and is either unavailable or difficult to access and may increase the chances of poor compliance. (Montoya, 2006)” It is imperative that care management models are applied in care transition which will allow for improved patient outcomes, the subsequent decrease in readmissions, and associated cost reductions within HF healthcare. Putting into place an adequate discharge plan of the HF health patients and ensuring delivery of adequate support services especially in the transition of the HF-patient form inpatient one to an outpatient one.

According to studies, the transitioning period following discharge carries a lot of risks especially for the patients with serious HF illness (SMI).The risk vary and mostly may be severe such as symptom relapse, an increased risk of homelessness, emergence of violent behaviors, some may result in killing themselves and in some instances the hospital readmissions. Although all these risks are properly documented, inadequacy in the proper planning among the patients and the care providers may

lead to their re-occurrence upon discharge. Thus, a proper and adequate planning is necessary, and this will reduce the readmission rates (Cuffel BJ, Held M, Goldman, 2002). According to Martin, M-L., Jensen, E., Coatsworth Puspoky et.al there are various models that been forwarded and tested especially in the general health area and they have shown that the elderly people are more vulnerable to hospital readmissions that the young people (general population).this is related to generally suboptimal health, disease-specific issues, family, and social factors.

Martin and the fellow researchers put a focus on several interventions that are aimed at reducing the rate of readmission in the hospitals rates. The care and intervention Model (CTI) are the most commonly used care post-hospitalization care for the HF patients. The major goal of the CTI is to help the patients and support then to promote their knowledge in the self-management during the transition period from the hospital. The CTI model is based on four major pillars that are, uses of a changing patient-centered record (PHR) a patient skill of the red-flag, a care and specialist follow-up which is usually patient initiated and lastly a medication self-management. This gives rise to the four components of care and intervention Model (CTI).The components include: a checklist which is structured to display the critical activities so as to empower the heart failure patients pre-discharge, a patient-centered record, an adequate transition and a frequent follow-up visit by the patients care taker and finally the patients self-activation and management session with the hospital specialist.

References

1. Mittler, J.N., O’Hora, J.L., Harvey, J.B., Press, M.J., Volpp, K.G., & Scanlon, D.P. (2013).
2. Turning readmission reduction policies into results:
   

some lessons from a multistate initiative to reduce readmissions. Population Health Management, 16(4), 255-260. doi:10.1089/pop.2012.0087. Montoya, I.D. (2006).