Posted: August 23rd, 2022

PICOT: For adults aged 40 and older with heart failure

PICOT: For adults aged 40 and older with heart failure in a primary care clinic, does the implementation of the Agency for Healthcare Research and Quality (AHRQ) Re-Engineered Discharge (RED) Toolkit via telemedicine, compared to current practice, impact 30-day readmission rates over 14 weeks?

Heart failure has been a predominant cause of death for nearly a century (Khan et al., 2020; Schrage et al., 2020). Readmissions related to the worsening disease process have significant repercussions for healthcare, including decreased reimbursement. An integrative review was completed to answer if utilizing the RED Toolkit coupled with telemedicine reduced heart failure readmissions. Results indicated decreased readmissions by upwards of 30%, improved morbidity and mortality rates, and quality of life (Hunt‐O’Connor et al., 2021; Jenneve et al., 2020; McKay et al., 2019; Mitchell et al., 2017; Patel & Dickerson, 2017; Roberts et al., 2018; Sullivan et al., 2018).


Hunt‐O’Connor, C., Moore, Z., Patton, D., Nugent, L., Avsar, P., & O’Connor, T. (2021). The effect of discharge planning on length of stay and readmission rates of older adults in acute hospitals: A systematic review and meta‐analysis of systematic reviews. Journal of Nursing Management, 29(8), 2697–2706. (Links to an external site.)

Jenneve, A., Lorenzo-Villalba, N., Courdier, G., Talha, S., Séverac, F., Zulfiqar, A.-A., Arnold, P., Lang, P., Roul, G., & Andrès, E. (2020). Benefit of ambulatory management of patients with chronic heart failure by protocolized follow-up therapeutic education and remote monitoring solution: An original study in 159 patients. Journal of Clinical Medicine, 9(10), 1–13. (Links to an external site.)

Khan, M., Hashim, M., Mustafa, H., Baniyas, M., Al Suwaidi, S., AlKatheeri, R., Alblooshi, F., Almatrooshi, M., Alzaabi, M., Al Darmaki, R., & Lootah, S. (2020). Global epidemiology of ischemic heart disease: Results from the global burden of disease study. Cureus, 1–12. (Links to an external site.)

McKay, C., Park, C., Chang, J., Brackbill, M., Choi, J.-Y., Lee, J., & Kim, S. (2019). Systematic review and meta-analysis of pharmacist-led transitions of care services on the 30-day all-cause readmission rate of patients with congestive heart failure. Clinical Drug Investigation, 39(8), 703–712. (Links to an external site.)

Mitchell, S. E., Weigel, G. M., Laurens, V., Martin, J., & Jack, B. W. (2017). Implementation and adaptation of the re-engineered discharge (red) in five California hospitals: A qualitative research study. BMC Health Services Research, 17(1). (Links to an external site.)

Patel, P. H., & Dickerson, K. W. (2017). Impact of the implementation of project re-engineered discharge for heart failure patients at a veterans affairs hospital at the central Arkansas veterans healthcare system. Hospital Pharmacy, 53(4), 266–271. (Links to an external site.)

Roberts, S., Moore, L. C., & Jack, B. (2018). Improving discharge planning using the re‐engineered discharge programme. Journal of Nursing Management, 27(3), 609–615. (Links to an external site.)

Schrage, B., Lund, L. H., Benson, L., Stolfo, D., Ohlsson, A., Westerling, R., Westermann, D., Strömberg, A., Dahlström, U., Braunschweig, F., Ferreira, J., & Savarese, G. (2020). Lower socioeconomic status predicts higher mortality and morbidity in patients with heart failure. Heart, 107(3), 229–236. (Links to an external site.)

Sullivan, J. L., Shin, M. H., Engle, R. L., Yaksic, E., VanDeusen Lukas, C., Paasche-Orlow, M. K., Starr, L. M., Restuccia, J. D., Holmes, S. K., & Rosen, A. K. (2018). Evaluating the implementation of project re-engineered discharge (RED) in five veterans health administration (VHA) hospitals. The Joint Commission Journal on Quality and Patient Safety, 44(11), 663–673.


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