Up to 50% of hospital readmissions for systolic or diastolic
CHF may be prevented with appropriate care.[16-18] A recent review
of published experience in disease management of CHF
examined 16 studies (ten observational, six randomized trials)
from 1983–1998.[19] Many types of interventions including nurse
case management, heart failure clinics, mailings/telemonitoring
and home health nursing reduced CHF readmissions by 14–87%.
The anchoring role of a specialized heart failure nurse who provided
education, proactive follow-up, evaluation and management
to patients was a critical component of success. The most
effective single model appeared to be a one-site nurse/physician/
clinic (i.e. one site which had one nurse, one physician and one
clinic).[20-22] The benefit to such programs appeared to wane over time with a gradual attrition of efficacy and resultant higher readmission
rates