Utilizing Risk Readmission Assessment Tool for Nonhospice Palliative Care Consults in Heart Failure Patients

Abstract

Background: Heart failure (HF) affects 5.1 million U.S. citizens with approximately half dying within 5 years of diagnosis, but many never receive palliative care consults or interventions. Objective: The purpose of this study was to review medical records of patients admitted and readmitted to the hospital with a primary diagnosis of HF, calculate the risk readmission assessment tool (RRAT) score to determine whether the patient was at high risk, and to determine whether a palliative care consult had been initiated. The tool scoring and medical record review were in retrospect of the hospital admission. Methods: A retrospective analysis was performed on 70 patients with primary diagnosis of HF who were readmitted at least one time during fiscal year 2012. The RRAT score was calculated on index admission. Patients with high risk scores were assessed for palliative care consult. Results: Forty-nine of the 70 patients scored high risk for readmission at their index admission. The other 21 patients scored moderate risk at the index admission but subsequently scored high risk on their second admission. A total of 35 patients received palliative care consults. Only 10 of those patients received palliative care consults on the index admission. Conclusion: Many healthcare providers are unsure when to consult nonhospice palliative care (NHPC) teams for patients with chronic diseases. The findings of this study are important, as they suggest an RRAT can assist with identifying patients with HF in need of NHPC consults.