Evaluation of the transitional care model in chronic heart failure.

摘要

BACKGROUND: Chronic heart failure (CHF) prevalence is on the increase in the UK, with readmissions to hospital and length of stay remaining a significant problem both for patients and the NHS. The role of the clinical nurse specialist in the management of CHF patients has yielded positive results in a number of previous studies. Aim: To evaluate the effectiveness of a transitional care service on readmissions and length of stay in hospital for patients with CHF. DESIGN: A quasi-experimental design was used over a period of 18 weeks. The historical group (n=50) and the transitional care group (n=47) were compared. METHOD: The study was carried out in an acute hospital trust. A patient questionnaire was used as a post-intervention measure. RESULTS: The number of readmissions was higher in the control group (14%; n=7) compared with the transitional care group (8.5%; n=4; P=0.526). Difference in length of stay for both groups almost achieved statistical significance (P=0.06). Patients gave positive feedback about the service. CONCLUSIONS: The results indicate that the introduction of the transitional care service did not reduce the number of readmissions. The length of stay, if anything, appeared to increase in the historical group when compared with the transitional group. Although it was clear that the two groups were different in important ways, causal effect cannot be attributed to the transitional care group as a result of these other differences. Results from the patient satisfaction questionnaires used in the transitional group did illustrate satisfaction with the discharge process and care received.