The H2H national quality improvement initiative is an effort to reduce cardiovascular-related hospital readmissions and improve the transition from inpatient to patient status for individuals hospitalized with cardiovascular disease.
Goal: To reduce 30 day, all-cause, risk standardized readmission rates for patients discharged with cardiac conditions
Areas for Improvement: Rather than imposing and advocating specific strategies, the H2H project provides a central clearinghouse of information and tools, building on what others are doing and have done to improve care transitions and reduce readmissions. H2H focuses on 3 evidence-based areas for improvement:
1. Early Follow-Up
Does the patient have a follow-up visit scheduled or cardiac rehabilitation referral within 1 week of hospital discharge?
2. Post-discharge Medication Management
Are the caregiver and patient teams working together to ensure optimal medication management?
3. Signs and Symptoms
Is the patient self-activated to recognize and appropriately act on warnings signs and symptoms?