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Early Look at ACC Navigator Program Shows Inpatient Mortality Drops as Hospitals Take Positive Steps

Mary Caffrey
In the next phase of the program, researchers will dig into the data they have gathered so far to identify the best practices for reducing 30- and 90-day readmission rates.
A quality improvement program to help heart attack and heart failure patients avoid readmission is showing early positive signs, according to research to be presented at the upcoming American College of Cardiology (ACC) 67th Scientific Session in Orlando, Florida. The conference takes place March 10-12, 2018.

Researchers for the ACC Patient Navigator Program, in place at 35 acute care hospitals, reported progress in all 6 processes of care designed to reduce readmissions, and they also reported that inpatient mortality after myocardial infarction (MI) has dropped from 4% to 3.7%.

While researchers are still gathering data for the 2-year program, that’s enough good news to move the program into a new phase. ACC Navigator Program: Focus MI will allow hospitals in the ACC's ACTION registry to share strategies and resources to reduce readmissions, and 15 of the 35 hospitals from the first phase of the navigator program will dig deeper into what they have learned so far and identify best practices to improve 30- and 90-day readmission rates.

Limiting 30- and 90-day readmissions is tied reimbursement under Quality Payment Program initiatives proposed by Medicare, and many commercial plans track these metrics, as well.

Data to be presented March 10 show that after 1 year, providers taking part in the ACC navigator initiative were:
  • 2.2% more likely to prescribe beta blockers
  • 7.4% more likely to schedule a follow-up appointment before patients were discharged, with the appointment coming within 7 days of discharge
  • 4.4% more likely to review home medications when patients were admitted
  • 0.2% more likely to review medications with patients at discharge
  • 4.8% more likely to review medications at admission and discharge
  • 8.8% more likely to educate patients about self-care, including when to contact a provider
“Hospital readmissions are devastating to patients and their families, and patients who are readmitted have a greater chance of mortality. Additionally, readmissions take a heavy toll on our entire healthcare system,” Nancy M. Albert, PhD, associate chief nursing officer, Office of Nursing Research and Innovation at Cleveland Clinic, said in a statement.

Albert said she was “encouraged” by a trend toward decreased heart failure readmissions, which were once seen as a lost cause in healthcare, prior to the advent of reimbursement incentives that penalized hospitals with high 30-day readmissions rates. Heart failure and heart attack patients often have other health conditions, such as diabetes, high blood pressure, or chronic lung disease; this may mean patients must manage a complex medication schedule.

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