Heart Failure

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UMPC - Physician Resources: Video Presentation on Congestive Heart Failure: New Approaches to an Old Problem

Scientific Articles

Recent Articles (Added 1/22)

Kiuchi K, Shirakabe A, Okazaki H, et al. The Prognostic Impact of Hospital Transfer after Admission due to Acute Heart Failure. Int Heart J. 2021;62(6):1310-1319. doi:10.1536/ihj.21-126. Abstract. Article.

Van Spall HGC, DeFilippis EM, Lee SF, et al. Sex-Specific Clinical Outcomes of the PACT-HF Randomized Trial. Circ Heart Fail. 2021;14(11):e008548. doi:10.1161/CIRCHEARTFAILURE.121.008548. Abstract.

Prior Articles:

Afari, M.E., Aoun, J., Khare, S. et al. Heart Fail Rev (2019). Article.

Al-Damluji MS, Dzara K, Hodshon B, et al. Association of Discharge Summary Quality with Readmission Risk for Patients Hospitalized with Heart Failure Exacerbation. Circulation Cardiovascular quality and outcomes. 2015;8(1):109-111. doi:10.1161/CIRCOUTCOMES.114.001476. AbstractArticle.

Albert NM, Barnason S, Deswal A, Hernandez A, Kociol R, Lee E, Paul S, Ryan CJ, White-Williams C; American Heart Association Complex Cardiovascular Patient and Family Care Committee of the Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Transitions of Care in Heart Failure: A Scientific Statement from the American Heart Association. Circ Heart Fail. 2015 Mar;8(2):384-409. doi:10.1161/HHF.0000000000000006. AbstractArticle.

Alspach JG. The Patient's Capacity for Self-care: Advocating for a Predischarge Assessment. Crit Care Nurse. 2011 Apr;31(2):10-4. doi: 10.4037/ccn2011419. AbstractArticle.

Arcilla D, Levin D, Sperber M. Transitioning Patients to Independence. Home Healthc Now. 2019 May-Jun;37(3):158-164. Abstract. 

Arora S, Patel P, Lahewala S, et al. Etiologies, Trends, and Predictors of 30-Day Readmission in Patients With Heart Failure. Am J Cardiol. 2017;119(5):760-769. doi:10.1016/j.amjcard.2016.11.022. Abstract.

Askren-Gonzalez A, Frater J. Case Management Programs for Hospital Readmission Prevention. Prof Case Manag. 2012 Sep-Oct;17(5):219-26; quiz 227-8. Abstract.

Averbuch T, Lee SF, Mamas MA, et al. Derivation and validation of a two-variable index to predict 30-day outcomes following heart failure hospitalization. ESC Heart Fail. 2021;8(4):2690-2697. doi:10.1002/ehf2.13324. AbstractArticle.

Baky V, Moran D, Warwick T, George A, Williams T, McWilliams E, Marine JE. Obtaining a follow-up appointment before discharge protects against readmission for patients with acute coronary syndrome and heart failure: A quality improvement project. Int J Cardiol. 2018 Apr 15:12-15. Abstract.   

Bamforth RJ, Chhibba R, Ferguson TW, et al. Strategies to prevent hospital readmission and death in patients with chronic heart failure, chronic obstructive pulmonary disease, and chronic kidney disease: A systematic review and meta-analysis. PLoS One. 2021;16(4):e0249542. Published 2021 Apr 22. doi:10.1371/journal.pone.0249542. AbstractArticle.

Basoor A, Doshi NC, Cotant JF, Saleh T, Todorov M, Choksi N, Patel KC, Degregorio M, Mehta RH, Halabi AR. Decreased Readmissions and Improved Quality of Care with the Use of an Inexpensive Checklist in Heart Failure. Congest Heart Fail. 2013 Jul-Aug;19(4):200-6. doi: 10.1111/chf.12031. AbstractArticle.

Berman T, Clark N, Lemieux AA. Impact of Pharmacist-Driven Heart Failure in-Home Counseling on 30-Day Readmission Rates. Prof Case Manag. 2019 Jul-Aug;24(4): 194-200. Abstract.

Bodagh, Neil & Farooqi, Fahad. (2017). Improving the quality of heart failure discharge summaries. British Journal of Cardiology. 24. 10.5837/bjc.2017.015. Article.

Boxer RS, Dolansky MA, Chaussee EL, et al. A Randomized Controlled Trial of Heart Failure Disease Management vs Usual Care in Skilled Nursing Facilities [published online ahead of print, 2021 Jun 16]. J Am Med Dir Assoc. 2021;S1525-8610(21)00506-5. doi:10.1016/j.jamda.2021.05.023. Abstract

Boykin A, Wright D, Stevens L, Gardner L. Interprofessional care collaboration for patients with heart failure. Am J Health Sys Pharm. 2018 Jan;75(1):e45-e49. Abstract.

Bradley EH, Sipsma H, Horwitz LI, et al. Hospital Strategy Uptake and Reductions in Unplanned Readmission Rates for Patients with Heart Failure: A Prospective Study. Journal of General Internal Medicine. 2015;30(5):605-611. doi:10.1007/s11606-014-3105-5. AbstractArticle.

Cabán PL. The Use of Home Telemonitoring for Heart Failure Management Among Hispanics, Non-Hispanic Blacks, and Non-Hispanic Whites. Home Healthc Now. 2019 Nov/Dec;37(6):345-349. Abstract.

Chava R, Karki N, Ketlogetswe K, Ayala T. Multidisciplinary rounds in prevention of 30-day readmissions and decreasing length of stay in heart failure patients: A community hospital based retrospective study. Medicine (Baltimore). 2019 Jul;98(27):e16233. AbstractArticle.

Chen C, Li X, Sun L, Cao S, Kang Y, Hong L, Liang Y, You G, Zhang Q. Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. ESC Heart Fail. 2019 Feb;6(1):164-173. AbstractArticle.

Comin-Colet J, Enjuanes C, Lupon J, Cainzos-Achirica M, Badosa N, Verdu JM. Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization. Rev Esp Cardiol (Engl Ed). 2016;69(10):951-961. doi:10.1016/j.rec.2016.05.001. Abstract.

Dadosky A, Overbeck H, Barbetta L, Bertke K, Corl M, Daly K, Hiles N, Rector N, Chung E, Menon S. Telemanagement of Heart Failure Patients Across the Post-Acute Care Continuum. Telemed J E Health. 2018 May;24(5):360-366. Abstract.

Dall TM, Askarinam Wagner RC, Zhang Y, Yang W, Arday DR, Gantt CJ. Outcomes and Lessons Learned from Evaluating TRICARE’s Disease Management Programs. American Journal of Managed Care. 2010;16(6):438-446. Abstract.

Dev S, Fawcett J, Ahmad S, Wu WC, Schwenke D. Implementation of early follow-up care after heart failure hospitalization. Am J Manag Care. 2021;27(2):e42-e47. Published 2021 Feb 1. doi:10.37765/ajmc.2021.88588. AbstractArticle.

Driscoll A, Dinh D, Prior D, et al. The Effect of Transitional Care on 30-Day Outcomes in Patients Hospitalised With Acute Heart Failure. Heart Lung Circ. 2020;29(9):1347-1355. doi:10.1016/j.hlc.2020.03.004. Abstract.

Edmonston DL, Wu J, Matsouaka RA, Yancy C, Heidenreich P, Piña IL, Hernandez A, Fonarow GC, DeVore AD. Association of post-discharge specialty outpatient visits with readmissions and mortality in high-risk heart failure patients. Am Heart J. 2019 Jun 1;212:101-12. Abstract.

Fahimi F, Guo Y, Tong SC, et al. A Vital Signs Telemonitoring Programme Improves the Dynamic Prediction of Readmission Risk in Patients with Heart Failure. AMIA Annu Symp Proc. 2021;2020:432-441. Published 2021 Jan 25. AbstractArticle.

Feltner C, Jones CD, Cené CW, Zheng ZJ, Sueta CA, Coker-Schwimmer EJ, Arvanitis M, Lohr KN, Middleton JC, Jonas DE. Transitional Care Interventions to Prevent Readmissions for Persons with Heart Failure: A Systematic Review and Meta-analysis. Ann Intern Med. 2014 Jun 3;160(11):774-84. doi: 10.7326/M14-0083. Review. Abstract.

Friedman DM, Goldberg JM, Molinsky RL, et al. A Virtual Cardiovascular Care Program for Prevention of Heart Failure Readmissions in a Skilled Nursing Facility Population: Retrospective Analysis. JMIR Cardio. 2021;5(1):e29101. Published 2021 Jun 1. doi:10.2196/29101. AbstractArticle.

Fylan B, Marques I, Ismail H, Breen L, Gardner P, Armitage G, Blenkinsopp A. Gaps, traps, bridges and props: a mixed-methods study of resilience in the medicines management system for patients with heart failure at hospital discharge. BMJ Open. 2019 Feb 1;9(2):bmjopen-2018. AbstractArticle.

Garnier A, Rouiller N, Gachoud D, Nachar C, Voirol P, Griesser AC, Uhlmann M, Waeber G, Lamy O. Effectiveness of a transition plan at discharge of patients hospitalized with heart failure: a before-and-after study. ESC Heart Fail. 2018 Aug;5(4):657-667. AbstractArticle.

Giakoumis M, Sargsyan D, Kostis JB, et al. Readmission and mortality among heart failure patients with history of hypertension in a statewide database. J Clin Hypertens (Greenwich). 2020;22(7):1263-1274. doi:10.1111/jch.13918. AbstractArticle.

González-Franco Á, Cerqueiro González JM, Arévalo-Lorido JC, et al. Morbidity and mortality in elderly patients with heart failure managed with a comprehensive care model vs. usual care: The UMIPIC program [published online ahead of print, 2021 Oct 3]. Rev Clin Esp (Barc). 2021;S2254-8874(21)00161-2. doi:10.1016/j.rceng.2021.05.007. Abstract.

Greene SJ, Fonarow GC, Vaduganathan M, Khan SS, Butler J, Gheorghiade M. The Vulnerable Phase After Hospitalization for Heart Failure. Nat Rev Cardiol. 2015 Apr;12(4):220-9. doi: 10.1038/nrcardio.2015.14. Epub 2015 Feb 10. Review. Abstract.

Greene SJ, O'Brien EC, Mentz RJ, Luo N, Hardy NC, Laskey WK, Heidenreich PA, Chang CL, Turner SJ, Yancy CW, Hernandez AF, Curtis LH, Peterson PN, Fonarow GC, Hammill BG. Home-Time After Discharge Among Patients Hospitalized With Heart Failure. J Am Coll Cardiol. 2018 Jun;71(23):2643-2652. AbstractArticle.

Griffin BR, Agarwal N, Amberker R, et al. An Initiative to Improve 30-Day Readmission Rates Using a Transitions-of-Care Clinic Among a Mixed Urban and Rural Veteran Population. J Hosp Med. 2021;16(10):583-588. doi:10.12788/jhm.3659. Abstract.

Grossetti F, Ieva F, Paganoni AM. A multi-state approach to patients affected by chronic heart failure : The value added by administrative data. Health Care Manag Sci. 2018 Jun;21(2):281-291. Abstract.  

Gunadi S, Upfield S, Pham ND, Yea J, Schmiedeberg MB, Stahmer GD. Development of a Collaborative Transitions-of-Care Program for Heart Failure Patients. American Journal of Health-System Pharmacy. 2015;72(13):1147-1152. doi:10.2146/ajhp140563. Abstract.

Gupta S, Zengul FD, Davlyatov GK, Weech-Maldonado R. Reduction in Hospitals' Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities. Inquiry. 2019 Jan-Dec;56. AbstractArticle.

Haynes SC, Tancredi DJ, Tong K, et al. The Effect of Rehospitalization and Emergency Department Visits on Subsequent Adherence to Weight Telemonitoring. J Cardiovasc Nurs. 2020;10.1097/JCN.0000000000000689. Abstract.

Henke RM, Karaca Z, Jackson P, Marder WD, Wong HS. Discharge Planning and Hospital Readmissions. Med Care Res Rev. 2016 May 4. pii: 1077558716647652. [Epub ahead of print]. Abstract.

Hilbert JP, Zasadil S, Keyser DJ, Peele PB. Using Decision Trees to Manage Hospital Readmission Risk for Acute Myocardial Infarction, Heart Failure, and Pneumonia. Appl Health Econ Health Policy. 2014 Dec;12(6):573-85. doi:10.1007/s40258-014-0124-7. AbstractArticle.

Horwitz LI, Moriarty JP, Chen C, et al. Quality of Discharge Practices and Patient Understanding at an Academic Medical Center. JAMA internal medicine. 2013;173(18):10.1001/jamainternmed.2013.9318. doi:10.1001/jamainternmed.2013.9318. AbstractArticle.

Hummel SL, Karmally W, Gillespie BW, Helmke S, Teruya S, Wells J, Trumble E, Jimenez O, Marolt C, Wessler JD, Cornellier ML, Maurer MS. Home-Delivered Meals Postdischarge From Heart Failure Hospitalization. Circ Heart Fail. 2018 Aug;11(8):e004886. AbstractArticle.

Huynh QL, Whitmore K, Negishi K, Marwick TH. Influence of Risk on Reduction of Readmission and Death by Disease Management Programs in Heart Failure. J Card Fail. 2019 May;25(5):330-339. Abstract.

Jentzer JC, Baran DA, van Diepen S, et al. Admission Society for Cardiovascular Angiography and Intervention shock stage stratifies post-discharge mortality risk in cardiac intensive care unit patients. Am Heart J. 2020;219:37‐46. Abstract.

Jepma P, Verweij L, Buurman BM, et al. The nurse-coordinated cardiac care bridge transitional care programme: a randomised clinical trial [published online ahead of print, 2021 Jul 24]. Age Ageing. 2021. doi:10.1093/ageing/afab146. Abstract.

Kalista T, Lemay V, Cohen L. Postdischarge Community Pharmacist-provided Home Services for Patients After Hospitalization for Heart Failure. J Am Pharm Assoc (2003). 2015 Jul-Aug;55(4):438-42. doi: 10.1331/JAPhA.2015.14235. Abstract.

Khera R, Wang Y, Bernheim SM, Lin Z, Krumholz HM. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States. BMJ. 2020 Jan 15;368. AbstractArticle.

Kim KL, Li L, Kuang M, Horwitz LI, Desai SM. Changes in Hospital Referral Patterns to Skilled Nursing Facilities Under the Hospital Readmissions Reduction Program. Med Care. 2019 Sep 1;57(9):695-701. Abstract.

Kitamura M, Izawa KP, Yaekura M, et al. Relationship among Activities of Daily Living, Nutritional Status, and 90 Day Readmission in Elderly Patients with Heart Failure. Int J Environ Res Public Health. 2019;16(24):5068. Published 2019 Dec 12. AbstractArticle.

Koser KD, Ball LS, Homa JK, Mehta V. An Outpatient Heart Failure Clinic Reduces 30-Day Readmission and Mortality Rates for Discharged Patients: Process and Preliminary Outcomes. J Nurs Res. 2018 Dec;26(6):393-398. Abstract.

Kripalani S, Chen G, Ciampa P, Theobald C, Cao A, McBride M, Dittus RS, Speroff T. A transition care coordinator model reduces hospital readmissions and costs. Contemp Clin Trials. 2019 Apr 25; Epub ahead of print. Abstract. 

Lee KK, Thomas RC, Tan TC, Leong TK, Steimle A, Go AS. The Heart Failure Readmission Intervention by Variable Early Follow-up (THRIVE) Study: A Pragmatic Randomized Trial. Circ Cardiovasc Qual Outcomes. 2020;13(10):e006553. doi:10.1161/CIRCOUTCOMES.120.006553. Abstract

Lee KK, Yang J, Hernandez AF, Steimle AE, Go AS. Post-discharge Follow-up Characteristics Associated With 30-Day Readmission After Heart Failure Hospitalization. Med Care. 2016 Apr;54(4):365-72. doi:10.1097/MLR.0000000000000492. Abstract. 

Logeart D, Berthelot E, Bihry N, et al. Early and short-term intensive management after discharge for patients hospitalized with acute heart failure: a randomized study (ECAD-HF) [published online ahead of print, 2021 Oct 9]. Eur J Heart Fail. 2021;10.1002/ejhf.2357. doi:10.1002/ejhf.2357. Abstract.

Luder HR, Frede SM, Kirby JA, Epplen K, Cavanaugh T, Martin-Boone JE, Conrad WF, Kuhlmann D, Heaton PC. TransitionRx: Impact of Community Pharmacy Postdischarge Medication Therapy Management on Hospital Readmission Rate. J Am Pharm Assoc (2003). 2015 May-Jun;55(3):246-54. doi: 10.1331/JAPhA.2015.14060. Abstract.

Madrigal C, Kim J, Jiang L, et al. Delirium and Functional Recovery in Patients Discharged to Skilled Nursing Facilities After Hospitalization for Heart Failure. JAMA Netw Open. 2021;4(3):e2037968. Published 2021 Mar 1. doi:10.1001/jamanetworkopen.2020.37968. AbstractArticle.

Mathew S, Thukha H. Pilot testing of the effectiveness of nurse-guided, patient-centered heart failure education for older adults. Geriatr Nurs. 2018 Jul - Aug;39(4):376-381. Abstract.

Matsukawa R, Masuda S, Matsuura H, et al. Early follow-up at outpatient care after discharge improves long-term heart failure readmission rate and prognosis. ESC Heart Fail. 2021;8(4):3002-3013. doi:10.1002/ehf2.13391. AbstractArticle.

McAlister FA, Youngson E, Bakal JA, Kaul P, Ezekowitz J, van Walraven C. Impact of Physician Continuity on Death or Urgent Readmission After Discharge Among Patients with Heart Failure. CMAJ : Canadian Medical Association Journal. 2013;185(14):E681-E689. doi:10.1503/cmaj.130048. AbstractArticle.

McCants KM, Reid KB, Williams I, Miller DE, Rubin R, Dutton S. The Impact of Case Management on Reducing Readmission for Patients Diagnosed With Heart Failure and Diabetes. Prof Case Manag. 2019 Jul-Aug;24(4):177-193. Abstract.

Mitchell JE, Chesler R, Zhang S, et al. Profile of Patients Hospitalized for Heart Failure Who Leave Against Medical Advice. J Card Fail. 2021;27(7):747-755. doi:10.1016/j.cardfail.2021.03.011. Abstract.

Morley CM, Levin SA. Health Literacy, Health Confidence, and Simulation: A Novel Approach to Patient Education to Reduce Readmissions. Prof Case Manag. 2021;26(3):138-149. doi:10.1097/NCM.0000000000000456. PubMed Record.

Moye PM, Chu PS, Pounds T, Thurston MM. Impact of a pharmacy team-led intervention program on the readmission rate of elderly patients with heart failure. Am J Health Syst Pharm. 2018 Feb;75(4):183-190. Abstract.  

Murphy JA, Schroeder MN, Rarus RE, Yakubu I, McKee SOP, Martin SJ. Implementation of a Cardiac Transitions of Care Pilot Program: A Prospective Study of Inpatient and Outpatient Clinical Pharmacy Services for Patients With Heart Failure Exacerbation or Acute Myocardial Infarction. J Pharm Pract. 2019 Feb;32(1):68-76. Abstract.

Nathan AS, Martinez JR, Giri J, Navathe AS. Observational study assessing changes in timing of readmissions around postdischarge day 30 associated with the introduction of the Hospital Readmissions Reduction Program. BMJ Qual Saf. 2021;30(6):493-499. doi:10.1136/bmjqs-2019-010780. Abstract

Ong MK, Romano PS, Edgington S, et al. Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition–Heart Failure (BEAT-HF) Randomized Clinical Trial. JAMA internal medicine. 2016;176(3):310-318. doi:10.1001/jamainternmed.2015.7712. AbstractArticle.

Pacho C, Domingo M, Núñez R, Lupón J, Moliner P, de Antonio M, González B, Santesmases J, Vela E, Tor J, Bayes-Genis A. Early Postdischarge STOP-HF-Clinic Reduces 30-day Readmissions in Old and Frail Patients With Heart Failure.  Rev Esp Cardiol (Engl Ed). 2017 Aug;70(8):631-638. AbstractArticle.

Patel J. Heart failure population health considerations. Am J Manag Care. 2021;27(9 Suppl):S191-S195. doi:10.37765/ajmc.2021.88673. AbstractArticle.

Peter D, Robinson P, Jordan M, Lawrence S, Casey K, Salas-Lopez D. Reducing Readmissions Using Teach-back: Enhancing Patient and Family Education. J Nurs Adm. 2015 Jan;45(1):35-42. doi: 10.1097/NNA.0000000000000155. Abstract.

Pham PN, Xiao H, Sarayani A, Chen M, Brown JD. Risk Factors Associated With 7- Versus 30-Day Readmission Among Patients With Heart Failure Using the Nationwide Readmission Database. Med Care. 2019 Jan;57(1):1-7. Abstract.

Piñeiro-Fernández JC, Fernández-Rial Á, Suárez-Gil R, et al. Evaluation of a patient-centered integrated care program for individuals with frequent hospital readmissions and multimorbidity [published online ahead of print, 2021 Oct 29]. Intern Emerg Med. 2021;10.1007/s11739-021-02876-9. doi:10.1007/s11739-021-02876-9. Abstract.

Poelzl G, Egelseer-Bruendl T, Pfeifer B, et al. Feasibility and effectiveness of a multidimensional post-discharge disease management programme for heart failure patients in clinical practice: the HerzMobil Tirol programme [published online ahead of print, 2021 Jul 16]. Clin Res Cardiol. 2021. doi:10.1007/s00392-021-01912-0. Abstract.

Pollard J, Oliver-McNeil S, Patel S, Mason L, Baker H. Impact of the Development of a Regional Collaborative to Reduce 30-Day Heart Failure Readmissions. J Nurs Care Qual. 2015 Oct-Dec;30(4):298-305. doi:10.1097/NCQ.0000000000000116. Abstract.  

Ponce SG, Norris J, Dodendorf D, Martinez M, Cox B, Laskey W. Impact of Ethnicity, Sex, and Socio-Economic Status on the Risk for Heart Failure Readmission: The Importance of Context. Ethn Dis. 2018 Apr 26;28(2):99-104. AbstractArticle.

Reese RL, Clement SA, Syeda S, et al. Coordinated-Transitional Care for Veterans with Heart Failure and Chronic Lung Disease. J Am Geriatr Soc. 2019;67(7):1502‐1507. Abstract. Article.

Regalbuto R, Maurer MS, Chapel D, Mendez J, Shaffer JA. Joint Commission Requirements for Discharge Instructions in Patients with Heart Failure: Is Understanding Important for Preventing Readmissions? Journal of cardiac failure. 2014;20(9):641-649. doi:10.1016/j.cardfail.2014.06.358. AbstractArticle.

Rice H, Say R, Betihavas V. The effect of nurse-led education on hospitalisation, readmission, quality of life and cost in adults with heart failure. A systematic review. Patient Educ Couns. 2017 Oct 5. pii: S0738-3991(17)30557-8. [Epub ahead of print]. Abstract.

Safdari R, Jafarpour M, Mokhtaran M, Naderi N. Designing and Implementation of a Heart Failure Telemonitoring System. Acta Inform Med. 2017 Sept;25(3):156-162. AbstractArticle.

Salas CM, Miyares MA. Implementing a Pharmacy Resident Run Transition of Care Service for Heart Failure Patients: Effect on Readmission Rates. Am J Health Syst Pharm. 2015 Jun 1;72(11 “Suppl 1):S43-7. doi: 10.2146/sp150012. Abstract.

Salata BM, Sterling MR, Beecy AN, Ullal AV, Jones EC, Horn EM, Goyal P. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services. Am J Cardiol. 2018 May 1;121(9):1076-1080. AbstractArticle.

Sawyer T, Nelson MJ, McKee V, Bowers MT, Meggitt C, Baxt SK, Washington D, Saladino L, Lehman EP, Brewer C, Locke SC, Abernethy A, Gilliss CL, Granger BB. Implementing Electronic Tablet-Based Education of Acute Care Patients. Crit Care Nurse. 2016 Feb;36(1):60-70. doi: 10.4037/ccn2016541. AbstractArticle.

Sperry BW, Ruiz G, Najjar SS. Hospital Readmission in Heart Failure, a Novel Analysis of a Longstanding Problem. Heart Fail Rev. 2015 May;20(3):251-8. doi:10.1007/s10741-014-9459-2. Review. Abstract.

Stevens S. Preventing 30-day Readmissions. Nurs Clin North Am. 2015 Mar;50(1):123-37. doi: 10.1016/j.cnur.2014.10.010. Abstract.

Still KL, Davis AK, Chilipko AA, Jenkosol A, Norwood DK. Evaluation of a Pharmacy-driven Inpatient Discharge Counseling Service: Impact on 30-day Readmission Rates. Consult Pharm. 2013 Dec;28(12):775-85. Doi: 10.4140/TCP.n.2013.775. Abstract.

Takeda A, Taylor SJ, Taylor RS, Khan F, Krum H, Underwood M. Clinical Service Organisation for Heart Failure. Cochrane Database of Systematic Reviews. 2012;(9). doi:10.1002/14651858.CD002752.pub3. Abstract.

Tan BY, Gu JY, Wei HY, Chen L, Yan SL, Deng N. Electronic medical record-based model to predict the risk of 90-day readmission for patients with heart failure. BMC Med Inform Decis Mak. 2019 Oct 15;19(1):193. AbstractArticle.

Tiozzo SN, Basso C, Capodaglio G, Schievano E, Dotto M, Avossa F, Fedeli U, Corti MC. Effectiveness of a community care management program for multimorbid elderly patients with heart failure in the Veneto Region. Aging Clin Exp Res. 2019 Jan 7;Epub ahead of print. Abstract.

Tsai PK, Wang RH, Lee CS, Tsai LM, Chen HM. Determinants of Self-care Decision-making in Hospitalised Patients with Heart Failure. J Clin Nurs. 2015 Apr;24(7-8):1101-11. doi: 10.1111/jocn.12722. Epub 2014 Nov 3. Abstract.

Turbow S, Sudharsanan N, Rask KJ, Ali MK. Association between interhospital care fragmentation, readmission diagnosis, and outcomes. Am J Manag Care. 2021;27(5):e164-e170. Published 2021 May 1. doi:10.37765/ajmc.2021.88639. AbstractArticle.

Uminski K, Komenda P, Whitlock R, Ferguson T, Nadurak S, Hochheim L, Tangri N, Rigatto C. Effect of post-discharge virtual wards on improving outcomes in heart failure and non-heart failure populations: A systematic review and meta-analysis. PLoS One. 2018 Apr;13(4):e0196114. AbstractArticle.

Unruh MA, Trivedi AN, Grabowski DC, Mor V. Does Reducing Length of Stay Increase Rehospitalization Among Medicare Fee-for-Service Beneficiaries Discharged to Skilled Nursing Facilities? Journal of the American Geriatrics Society. 2013;61(9):1443-1448. doi:10.1111/jgs.12411. AbstractArticle.

Van Spall HGC, Lee SF, Xie F, Oz UE, Perez R, Mitoff PR, Maingi M, Tjandrawidjaja MC, Heffernan M, Zia MI, Porepa L, Panju M, Thabane L, Graham ID, Haynes RB, Haughton D, Simek KD, Ko DT, Connolly SJ. Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. JAMA. 2019 Feb 26;321(8):753-761. Abstract.

Van Spall HGC, Rahman T, Mytton O, Ramasundarahettige C, Ibrahim Q, Kabali C, Coppens M, Brian Haynes R, Connolly S. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017 Nov;19(11):1427-1443. Abstract.

Wadhera RK, Joynt Maddox KE, Kazi DS, Shen C, Yeh RW. Hospital revisits within 30 days after discharge for medical conditions targeted by the Hospital Readmissions Reduction Program in the United States: national retrospective analysis. BMJ. 2019 Aug 12. AbstractArticle.

Wadhera RK, Joynt Maddox KE, Wasfy JH, Haneuse S, Shen C, Yeh RW. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. JAMA. 2018 Dec 25;320(24):2542-2552. AbstractArticle.

Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. J Am Med Dir Assoc. 2019 Apr;20(4):432-437. Abstract.

Wei S, McConnell ES, Corazzini KN, Moody J, Pan W, Granger B. Relational processes in heart failure care transitions: A data-driven case report. Heart Lung. 2021;50(5):622-626. doi:10.1016/j.hrtlng.2021.04.012. Abstract.

Whitaker-Brown CD, Woods SJ, Cornelius JB, Southard E, Gulati SK. Improving quality of life and decreasing readmissions in heart failure patients in a multidisciplinary transition-to-care clinic. Heart & Lung. 2017;46(2):79-84. doi:10.1016/j.hrtlng.2016.11.003. Abstract.

Wideqvist M, Cui X, Magnusson C, Schaufelberger M, Fu M. Hospital readmissions of patients with heart failure from real world: timing and associated risk factors. ESC Heart Fail. 2021;8(2):1388-1397. doi:10.1002/ehf2.13221. AbstractArticle.

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