{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:46:28Z","timestamp":1755218788501,"version":"3.43.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"\n Objectives:<\/jats:title>\n Congestive heart failure (CHF) is the most common cause of 30-day inpatient readmission. Studies have found that early follow-up with primary care physicians (PCP) within 7 days of discharge may improve 30-day readmission rates; however, many have used a multidisciplinary discharge coordination team, which is not a resource at all centers. Here, the authors present a resident-driven quality improvement initiative using a monthly quality and safety award to increase early PCP follow-up for veterans discharged following admissions due to a CHF exacerbation. Primary outcomes were percentage of PCP follow-up within 7 days and median time to PCP follow-up. Secondary outcomes included percentage of patients attending a PCP visit within 7 days, 30-day readmission, and 30-day mortality.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This prepost quasi-experimental cohort study evaluated 3 concurrent quality improvement interventions to increase PCP follow-up after CHF exacerbation. Process maps and Ishikawa diagrams examined the discharge process. Interventions included a standardized discharge scheduling order, monthly education on the process, and monthly aggregated performance feedback for each medical resident. A patient safety and quality award was given to the team with the highest rate of PCP appointments scheduled within 7 days. Patient characteristics and outcomes were gathered for a 6-month historic period and 6-month intervention period. Test of proportions and Wilcoxon Rank-Sum test were used to compare groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 294 patients were discharged (161 in historic group and 133 in intervention group). Appointments scheduled within 7 days of discharge increased from 43% to 79% (P<\/jats:italic> < 0.001). Median time to PCP follow-up decreased from 8 to 6 days (P<\/jats:italic> < 0.001). Patients who completed (showed up to) a PCP appointment within 7 days increased from 16% to 41% (P<\/jats:italic> < 0.001). There was no impact on 30-day readmission or mortality; however, the number of study subjects was too small to rule out an effect.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n A standardized discharge scheduling order, more robust resident education, and a monthly patient safety and quality award resulted in a significant increase in the rate of primary care follow-up within 7 days of CHF exacerbation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/jmq.0000000000000037","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T19:25:42Z","timestamp":1641497142000},"page":"314-320","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Resident-driven Quality Improvement Project to Increase Primary Care Follow-up after Congestive Heart Failure Exacerbation: Use of a Quality and Safety Award"],"prefix":"10.1097","volume":"37","author":[{"given":"Lea M.","family":"Monday","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI"},{"name":"Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, Detroit Medical Center, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omid","family":"Yazdanpanah","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, Detroit Medical Center, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Solokowski","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Chi","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, Detroit Medical Center, Detroit, MI"},{"name":"Division of General Internal Medicine, Department of Internal Medicine, John D. Dingell Veterans Affairs Medical Center, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kareem","family":"Bazzy","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine, Detroit, MI"},{"name":"Division of General Internal Medicine, Department of Internal Medicine, Detroit Medical Center, Detroit, MI"},{"name":"Division of General Internal Medicine, Department of Internal Medicine, John D. Dingell Veterans Affairs Medical Center, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"R1-20250806","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jacc.2012.09.038","article-title":"Rehospitalization for heart failure: problems and perspectives.","volume":"61","author":"Gheorghiade","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"R2-20250806","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1161\/HHF.0b013e318291329a","article-title":"Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association.","volume":"6","author":"Heidenreich","year":"2013","journal-title":"Circ Heart Fail"},{"key":"R4-20250806","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1001\/jama.2017.8444","article-title":"Association of changing hospital readmission rates with mortality rates after hospital discharge.","volume":"318","author":"Dharmarajan","journal-title":"JAMA"},{"key":"R6-20250806","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s10741-018-9754-4","article-title":"Updates in heart failure 30-day readmission prevention.","volume":"24","author":"Goldgrab","year":"2019","journal-title":"Heart Fail Rev"},{"key":"R7-20250806","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1001\/jama.2010.533","article-title":"Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure.","volume":"303","author":"Hernandez","year":"2010","journal-title":"JAMA"},{"key":"R8-20250806","doi-asserted-by":"crossref","first-page":"e0170061","DOI":"10.1371\/journal.pone.0170061","article-title":"Relationship between early physician follow-up and 30-day readmission after acute myocardial infarction and heart failure.","volume":"12","author":"Tung","year":"2017","journal-title":"PLoS One"},{"key":"R9-20250806","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.amjmed.2013.06.027","article-title":"Change in readmissions and follow-up visits as part of a heart failure readmission quality improvement initiative.","volume":"126","author":"Ryan","year":"2013","journal-title":"Am J Med"},{"key":"R10-20250806","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1177\/0018578718797263","article-title":"Effect of pharmacist clinic visits on 30-day heart failure readmission rates at a county hospital.","volume":"54","author":"Hahn","year":"2019","journal-title":"Hosp Pharm"},{"key":"R12-20250806","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/0018578717749925","article-title":"Impact of the implementation of project re-engineered discharge for heart failure patients at a veterans affairs hospital at the central Arkansas veterans healthcare system.","volume":"53","author":"Patel","year":"2018","journal-title":"Hosp Pharm"},{"key":"R13-20250806","first-page":"e7420","article-title":"Reducing all-cause 30-day hospital readmissions for patients presenting with acute heart failure exacerbations: a quality improvement initiative.","volume":"12","author":"Nair","year":"2020","journal-title":"Cureus"},{"key":"R14-20250806","doi-asserted-by":"crossref","first-page":"e000386","DOI":"10.1136\/bmjoq-2018-000386","article-title":"Putting veterans with heart failure FIRST improves follow-up and reduces readmissions.","volume":"8","author":"Ogunwole","year":"2019","journal-title":"BMJ Open Qual"},{"key":"R16-20250806","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/MLR.0000000000000492","article-title":"Post-discharge follow-up characteristics associated with 30-day readmission after heart failure hospitalization.","volume":"54","author":"Lee","year":"2016","journal-title":"Med Care"}],"container-title":["American Journal of Medical Quality"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/JMQ.0000000000000037","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T12:03:04Z","timestamp":1754481784000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/JMQ.0000000000000037"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,4]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/jmq.0000000000000037","relation":{},"ISSN":["1062-8606"],"issn-type":[{"type":"print","value":"1062-8606"}],"subject":[],"published":{"date-parts":[[2022,1,4]]}}}