Matagorda Regional Medical Combats High Heart Failure Readmission Rates

Matagorda Regional Medical Center, a 58-bed facility in Bay City, Texas, discovered that their heart failure (HF) 30-day readmission rates were 22.7% in the fourth quarter of 2022, which was higher than the Centers for Medicare & Medicaid Services (CMS) National Observed Readmission rate of 21.1%. As a result, the hospital was penalized by CMS and quality improvement staff were prompted to find new interventions.

Donna Harkreader, Matagorda’s director of quality and patient safety, consulted with the chief nursing officer and the directors of case management, medical/surgical, intensive care unit (ICU) and nutrition services to develop a patient education program to combat the high HF readmission rates.

On March 1, 2023, with the support of the Medical Care Review Committee and Quality Improvement Council, Matagorda rolled out the new project focusing on patients admitted for observation or inpatient status with a principal diagnosis of HF and who were discharged to either “home” or “home with home health.” Those patients received a hospital-branded folder with a red heart sticker that contained an HF Self-Check Plan from the American Heart Association, available in both English and Spanish. Matagorda even included a magnet clip with the folders so patients could hang the Self-Check Plan on their refrigerators as a daily reminder. In May, Matagorda enhanced their efforts by adding a Heart Healthy Eating Plan insert to the folders.

Matagorda saw HF readmission rates drop to 10.3% in the first quarter of 2023, and 11.8% in the second. Harkreader reports that patients have been very receptive to the education and follow-up phone call program, and that attending physicians are engaged and supportive of the project.

”We learned that even if you can't do everything, it doesn't mean you can't do anything,” said Harkreader. ”We are a small rural hospital and don’t have the resources to take our patients to their follow-up appointments or to the grocery store. We started small in a collaborative, multi-disciplinary fashion and achieved success quickly.”

Staff believe its multi-disciplinary approach was key to the success of the intervention. Sharing the work between quality, case management, nursing and nutrition services prevented any one department from being overloaded. Additionally, including the facility’s chief executive officer as executive sponsor signaled to everyone that the program is important.

TMF Health Quality Institute provided quality improvement resources and hosted an affinity group series on reducing hospital readmissions that helped Matagorda’s team learn strategies from other hospitals for HF readmission reduction. Based on tactics shared during the affinity group, the team would like to coordinate a Patient and Family Advisory Council with an HF focus to help patients learn more about healthy choices at the grocery store.
“We will continue to tweak our HF readmissions reduction process and monitor outcomes,” stated Harkreader. “In the future, we hope to expand the project to include all of our patients with chronic heart failure, not just those with a principle diagnosis.”