{"id":{"repo_id":"ku","oai_identifier":"oai:kuscholarworks.ku.edu:1808/36628"},"canonical_url":"https://search.dev.ndltd.org/etd/ku/oai:kuscholarworks.ku.edu:1808/36628","repository":{"repo_id":"ku","name":"University of Kansas","base_url":"https://kuscholarworks.ku.edu/server/oai/request"},"display":{"title":"Identifying Factors Contributing to Post-discharge Appointment Attendance for Patients with Heart Failure: A Quality Improvement Project","abstract":"Problem: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. As a quality measure to reduce readmissions and improve HF management, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend patients hospitalized with HF have a follow-up appointment within seven days of discharge. Despite its importance, the post-discharge follow-up appointment is not always scheduled for patients. In addition, only 30%-50% of the scheduled follow-up appointments are kept. Patients not scheduled for their one-week post-discharge HF follow-up appointment are more susceptible to inadequate HF management, leading to decreased patient outcomes, increased hospital readmissions, and the potential for reduced healthcare reimbursement rates and lost revenue.Project Aim: The purpose of this project was to identify reasons why HF patients do not attend one-week post-discharge follow-up appointments while offering potential solutions. The aims of the project included: (1) describing the HF inpatient discharge scheduling process in one Midwestern hospital, (2) identifying patients’ perceived barriers and facilitators to adherence of the one-week post-discharge follow-up appointment, and (3) provide recommendations to improve patient adherence.Project Method: This quality improvement project utilized a cross-sectional design and incorporated Donabedian’s framework. The sample population included adults admitted to a hospital in the Midwest with a primary diagnosis of HF and discharged to home throughout February 2022. The project aims were met by developing a process map, conducting patient surveys, and performing a retrospective chart review.Results: The scheduling and attendance rates for the one-week post-discharge HF follow-up appointment at this institution were higher than expected, at 72.5% and 76%, respectively. Facilitators identified for appointment scheduling and adherence included centralized scheduling, an appointment notification system, and a 72-hour transitional care phone call. This hospital’s HF Cardiology Rounding Team (HF-CRT) provided specific HF support for patients admitted to the Advanced HF Service, ensuring a one-week post-discharge follow-up appointment was scheduled, however the HF-CRT did not assist most patients hospitalized with HF who were admitted to other medical services. Patients with concomitant end-stage renal disease or discharged with home health were scheduled least often for the one-week post-discharge follow-up appointment. The most common patient-reported barriers for attendance included transportation concerns and limited appointment availability at preferred clinic locations.Conclusion: Centralized scheduling, an appointment notification system, and the 72-hour transitional care phone call were designated as facilitators for scheduling and attending the one-week post-discharge HF follow-up appointment at this institution. Process mapping and patient surveys revealed gaps in care, which made certain patients more susceptible to not receive the one-week post-discharge HF follow-up appointment. Recommended actions to improve appointment scheduling and adherence were to assign the HF-CRT to all patients hospitalized with HF, place a “hard stop” on the quality measures order set to enforce provider compliance, extend complete HF care to patients with home health, and reserve daily appointment slots at each HF clinic to improve post-discharge appointment availability.","abstract_html":"Problem: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. As a quality measure to reduce readmissions and improve HF management, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend patients hospitalized with HF have a follow-up appointment within seven days of discharge. Despite its importance, the post-discharge follow-up appointment is not always scheduled for patients. In addition, only 30%-50% of the scheduled follow-up appointments are kept. Patients not scheduled for their one-week post-discharge HF follow-up appointment are more susceptible to inadequate HF management, leading to decreased patient outcomes, increased hospital readmissions, and the potential for reduced healthcare reimbursement rates and lost revenue.Project Aim: The purpose of this project was to identify reasons why HF patients do not attend one-week post-discharge follow-up appointments while offering potential solutions. The aims of the project included: (1) describing the HF inpatient discharge scheduling process in one Midwestern hospital, (2) identifying patients’ perceived barriers and facilitators to adherence of the one-week post-discharge follow-up appointment, and (3) provide recommendations to improve patient adherence.Project Method: This quality improvement project utilized a cross-sectional design and incorporated Donabedian’s framework. The sample population included adults admitted to a hospital in the Midwest with a primary diagnosis of HF and discharged to home throughout February 2022. The project aims were met by developing a process map, conducting patient surveys, and performing a retrospective chart review.Results: The scheduling and attendance rates for the one-week post-discharge HF follow-up appointment at this institution were higher than expected, at 72.5% and 76%, respectively. Facilitators identified for appointment scheduling and adherence included centralized scheduling, an appointment notification system, and a 72-hour transitional care phone call. This hospital’s HF Cardiology Rounding Team (HF-CRT) provided specific HF support for patients admitted to the Advanced HF Service, ensuring a one-week post-discharge follow-up appointment was scheduled, however the HF-CRT did not assist most patients hospitalized with HF who were admitted to other medical services. Patients with concomitant end-stage renal disease or discharged with home health were scheduled least often for the one-week post-discharge follow-up appointment. The most common patient-reported barriers for attendance included transportation concerns and limited appointment availability at preferred clinic locations.Conclusion: Centralized scheduling, an appointment notification system, and the 72-hour transitional care phone call were designated as facilitators for scheduling and attending the one-week post-discharge HF follow-up appointment at this institution. Process mapping and patient surveys revealed gaps in care, which made certain patients more susceptible to not receive the one-week post-discharge HF follow-up appointment. Recommended actions to improve appointment scheduling and adherence were to assign the HF-CRT to all patients hospitalized with HF, place a “hard stop” on the quality measures order set to enforce provider compliance, extend complete HF care to patients with home health, and reserve daily appointment slots at each HF clinic to improve post-discharge appointment availability.","abstract_has_math":false,"creators":["Pettus, Angie"],"institution":"University of Kansas","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Trees, Karen K"],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022-05-31","date_published":"2022-05-31","updated_at":"2026-07-24T02:45:54Z","subjects":["Health care management","Medicine","Nursing","attendance rate","heart failure","no-show","quality measures","scheduling rate"],"languages":["en"],"rights":["Copyright held by the author."],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["http://dissertations.umi.com/ku:18227"],"render_values":[{"text":"http://dissertations.umi.com/ku:18227","href":"http://dissertations.umi.com/ku:18227","code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/1808/36628","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Trees, Karen K"]},{"key":"dc:creator","label":"Author","values":["Pettus, Angie"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-04-08T20:03:57Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2026-04-08T20:03:57Z"]},{"key":"dc:date.issued","label":"Date","values":["2022-05-31"]},{"key":"dc:publisher","label":"Institution","values":["University of Kansas"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Health care management","Medicine","Nursing","attendance rate","heart failure","no-show","quality measures","scheduling rate"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["Copyright held by the author."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["http://dissertations.umi.com/ku:18227"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/1808/36628"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Problem: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. As a quality measure to reduce readmissions and improve HF management, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend patients hospitalized with HF have a follow-up appointment within seven days of discharge. Despite its importance, the post-discharge follow-up appointment is not always scheduled for patients. In addition, only 30%-50% of the scheduled follow-up appointments are kept. Patients not scheduled for their one-week post-discharge HF follow-up appointment are more susceptible to inadequate HF management, leading to decreased patient outcomes, increased hospital readmissions, and the potential for reduced healthcare reimbursement rates and lost revenue.Project Aim: The purpose of this project was to identify reasons why HF patients do not attend one-week post-discharge follow-up appointments while offering potential solutions. The aims of the project included: (1) describing the HF inpatient discharge scheduling process in one Midwestern hospital, (2) identifying patients’ perceived barriers and facilitators to adherence of the one-week post-discharge follow-up appointment, and (3) provide recommendations to improve patient adherence.Project Method: This quality improvement project utilized a cross-sectional design and incorporated Donabedian’s framework. The sample population included adults admitted to a hospital in the Midwest with a primary diagnosis of HF and discharged to home throughout February 2022. The project aims were met by developing a process map, conducting patient surveys, and performing a retrospective chart review.Results: The scheduling and attendance rates for the one-week post-discharge HF follow-up appointment at this institution were higher than expected, at 72.5% and 76%, respectively. Facilitators identified for appointment scheduling and adherence included centralized scheduling, an appointment notification system, and a 72-hour transitional care phone call. This hospital’s HF Cardiology Rounding Team (HF-CRT) provided specific HF support for patients admitted to the Advanced HF Service, ensuring a one-week post-discharge follow-up appointment was scheduled, however the HF-CRT did not assist most patients hospitalized with HF who were admitted to other medical services. Patients with concomitant end-stage renal disease or discharged with home health were scheduled least often for the one-week post-discharge follow-up appointment. The most common patient-reported barriers for attendance included transportation concerns and limited appointment availability at preferred clinic locations.Conclusion: Centralized scheduling, an appointment notification system, and the 72-hour transitional care phone call were designated as facilitators for scheduling and attending the one-week post-discharge HF follow-up appointment at this institution. Process mapping and patient surveys revealed gaps in care, which made certain patients more susceptible to not receive the one-week post-discharge HF follow-up appointment. Recommended actions to improve appointment scheduling and adherence were to assign the HF-CRT to all patients hospitalized with HF, place a “hard stop” on the quality measures order set to enforce provider compliance, extend complete HF care to patients with home health, and reserve daily appointment slots at each HF clinic to improve post-discharge appointment availability."]},{"key":"dc:title","label":"Title","values":["Identifying Factors Contributing to Post-discharge Appointment Attendance for Patients with Heart Failure: A Quality Improvement Project"]}]}],"canonical_facts":{"dc:contributor.advisor":["Trees, Karen K"],"dc:creator":["Pettus, Angie"],"dc:date.accessioned":["2026-04-08T20:03:57Z"],"dc:date.available":["2026-04-08T20:03:57Z"],"dc:date.issued":["2022-05-31"],"dc:description.abstract":["Problem: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. As a quality measure to reduce readmissions and improve HF management, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend patients hospitalized with HF have a follow-up appointment within seven days of discharge. Despite its importance, the post-discharge follow-up appointment is not always scheduled for patients. In addition, only 30%-50% of the scheduled follow-up appointments are kept. Patients not scheduled for their one-week post-discharge HF follow-up appointment are more susceptible to inadequate HF management, leading to decreased patient outcomes, increased hospital readmissions, and the potential for reduced healthcare reimbursement rates and lost revenue.Project Aim: The purpose of this project was to identify reasons why HF patients do not attend one-week post-discharge follow-up appointments while offering potential solutions. The aims of the project included: (1) describing the HF inpatient discharge scheduling process in one Midwestern hospital, (2) identifying patients’ perceived barriers and facilitators to adherence of the one-week post-discharge follow-up appointment, and (3) provide recommendations to improve patient adherence.Project Method: This quality improvement project utilized a cross-sectional design and incorporated Donabedian’s framework. The sample population included adults admitted to a hospital in the Midwest with a primary diagnosis of HF and discharged to home throughout February 2022. The project aims were met by developing a process map, conducting patient surveys, and performing a retrospective chart review.Results: The scheduling and attendance rates for the one-week post-discharge HF follow-up appointment at this institution were higher than expected, at 72.5% and 76%, respectively. Facilitators identified for appointment scheduling and adherence included centralized scheduling, an appointment notification system, and a 72-hour transitional care phone call. This hospital’s HF Cardiology Rounding Team (HF-CRT) provided specific HF support for patients admitted to the Advanced HF Service, ensuring a one-week post-discharge follow-up appointment was scheduled, however the HF-CRT did not assist most patients hospitalized with HF who were admitted to other medical services. Patients with concomitant end-stage renal disease or discharged with home health were scheduled least often for the one-week post-discharge follow-up appointment. The most common patient-reported barriers for attendance included transportation concerns and limited appointment availability at preferred clinic locations.Conclusion: Centralized scheduling, an appointment notification system, and the 72-hour transitional care phone call were designated as facilitators for scheduling and attending the one-week post-discharge HF follow-up appointment at this institution. Process mapping and patient surveys revealed gaps in care, which made certain patients more susceptible to not receive the one-week post-discharge HF follow-up appointment. Recommended actions to improve appointment scheduling and adherence were to assign the HF-CRT to all patients hospitalized with HF, place a “hard stop” on the quality measures order set to enforce provider compliance, extend complete HF care to patients with home health, and reserve daily appointment slots at each HF clinic to improve post-discharge appointment availability."],"dc:identifier.other":["http://dissertations.umi.com/ku:18227"],"dc:identifier.uri":["https://hdl.handle.net/1808/36628"],"dc:language.iso":["en"],"dc:publisher":["University of Kansas"],"dc:rights":["Copyright held by the author."],"dc:subject":["Health care management","Medicine","Nursing","attendance rate","heart failure","no-show","quality measures","scheduling rate"],"dc:title":["Identifying Factors Contributing to Post-discharge Appointment Attendance for Patients with Heart Failure: A Quality Improvement Project"],"dc:type":["Dissertation"]},"updated_at":"2026-07-24T02:45:54Z"}