Improving Care of Children with Acute Decompensated Heart Failure (ADHF) Through Implementation of a Heart Failure Communication Checklist & Discharge Plan
Doctor of Nursing Practice (DNP)
Doctor of Nursing Practice (DNP) Program
School of Nursing
pediatric heart failure, acute decompensated heart failure (ADHF), nurse rounding tools, interprofessional collaboration, and collaborative learning networks
Background: Children admitted to the hospital with ADHF have been identified as a low volume high complexity population with high morbidity and mortality rates. Hospitalizations are fraught with prolonged lengths of stay and frequent readmissions prompting increased resource utilization and significant healthcare costs. Pediatric collaborative learning networks, such as the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) seek to close quality gaps by engaging multidisciplinary multi-institutional teams along with patients and caregivers to share expertise, experience, and data prompting translation of evidence into higher quality, safer, cost-effective care.
Methods: A13-item pediatric-specific Heart Failure Communication Checklist (HFcc) and Heart Failure Discharge Plan (HFdc) which standardized language usage and team communication for hospitalized heart failure patients was piloted in iterative Plan-Do-Study-Act cycles throughout the ACTION network.
Results: Between January 26, 2021, and October 5, 2021, 16 sites within the ACTION network used the HFcc in 112 patients (a total of 1483 uses) with increased form usage over time. The median length of stay was 16.5 days. For 31 patients with follow up data, 8 were readmitted. For patients with both HFcc and outcome data, HFcc use was recorded 23% of hospital days (935/4121 days). Conclusion: Iterative PDSA cycles with rounding checklists were successfully conducted throughout the ACTION collaborative learning network promoting participation across centers and improvement within centers. This collaborative learning methodology propagates ongoing quality improvement endeavors with commitment to standardizing rounding protocols and promoting smoother transition to outpatient care.
Schneck, Dana M., "Improving Care of Children with Acute Decompensated Heart Failure (ADHF) Through Implementation of a Heart Failure Communication Checklist & Discharge Plan" (2021). Doctor of Nursing Practice (DNP) Manuscripts. 33.