Evaluating the Impact of a Clinical Heart Failure Management Pathway on Hospital Length of Stay and Readmission Rates

Abstract

Background: One of the major causes of hospitalization in the world is heart failure (HF) with a long length of stay (LOS) and high readmission rates. Multidisciplinary clinical pathways are suggested as the best way to streamline care, enhance outcomes, and decrease healthcare use, but their effect in practice has not been studied in detail.

Aim: To compare the impact of a multidisciplinary heart failure management pathway on hospital LOS and 30-day and 60-day readmission rates.

Materials and Methods: A retrospective observational study was carried out in King Fahd Armed Forces Hospital, Jeddah, in 86 adult patients with HF (43 pre-implementation in 2023 and 43 post-implementation in 2024). Demographic, comorbidity, ejection fraction, LOS, readmissions, and compliance with pathway elements data were gathered. Statistical analysis involved Wilcoxon signed-rank tests of LOS, chi-square tests of readmission rates, and multivariate regression to determine outcome predictors. A p-value of ≤ 0.05 was considered significant.

Results: Median LOS was reduced after implementation, from 7 days (IQR 510) to 5days (p = 0.001). The readmission rates decreased as the 30-day rate dropped to 11.6% (p = 0.042), and the 60-day rate dropped to 18.6% (p = 0.023).

Conclusion: A structured multidisciplinary HF management pathway proved to be effective in patient outcome optimization and utilization of healthcare resources by leading to a significant decrease in hospital LOS and readmission rates.