ArticleJACC. Case reports2025
Reducing Heart Failure Readmissions Through an Advanced Practice Nurse-Led Clinic With Navigator Support.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAcute heart failure is a leading cause of hospital readmissions, with nearly 20% rehospitalized within 30 days. Our institution's rate was over 27%, exceeding the national average. PROJECT RATIONALE: To reduce readmissions, we launched an Advanced Practice Nurse-led clinic supported by Heart Failure Navigators. The strategy focused on lifestyle education, proactive monitoring, and coordinated care. PROJECT SUMMARY: Between 2021 and 2024, we followed up with adult patients discharged with New York Heart NYHA functional class II to IV heart failure, implementing telemonitoring, lifestyle coaching, guideline-directed medical therapy, and proactive outreach by Heart Failure Navigators. TAKE-HOME MESSAGES: Advanced practice nurses, with navigator support, reduce readmissions, boost medication adherence, and improve quality of life and outcomes.
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