The Development and Implementation of a Cardiac Home Hospice Program: Results of a RE-AIM Analysis.
Lizeyka Jordan, David Russell, Dawon Baik and 2 others
PMID 32421373WHAT IT FOUND
Heart failure hospice enrollment rose from 7.9% to 9.5% after a specialized cardiac home hospice program began.
Nurses reported interdisciplinary support helped manage patients at home.
Key findings
01Heart failure patients rose from 7.9% of all enrolled patients in hospice before implementation to 9.5% in March 2017.
02Average length of hospice service decreased to 62.5 days in Year 4 from 92.2 days in Year 3, 81.6 days in Year 2, and 98.8 days in Year 1.
03Nurses described that having a clinical champion to call gave them confidence to provide more complex home hospice interventions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The program was studied at a single large non-profit agency in the northeastern U.S., so it may not fit smaller hospice agencies in other regions. Only one year of post-implementation data was available. The authors could not tell whether the rise in heart failure admissions was due to the program or national trends. Cardiologists were not interviewed, although hospice team members across disciplines were. The decrease in length of stay could reflect more acutely ill patients or live discharges, not only program effects.
Declared interests
The authors declare that there is no conflict of interest.
The easy way to misread this
Do not read the rise from 7.9% to 9.5% as proof that the program improved patient symptoms or reduced hospitalizations. The study compares years before and after implementation, reports provider views, and could not separate the increase from national trends.