Optimization of Heart Failure Patients Discharge Plan in Rajaie Cardiovascular Medical and Research Center: An Action Research

Background: Chronic heart failure can lead to frequent hospitalizations. Improving the dischargeplanning is an approach to reduce hospitalization. Since there has not been enough structured andeffective discharge plan in Iranian hospitals, the present study was designed to optimize this program.Method: This is a participatory action research based on Hart and Bond’s framework, conductedin a cardiovascular center in Iran from June 2016 to April 2018 during two cycles. Based on theoptimization strategies obtained through semistructured interviews with 15 participants, three focusgroup discussions and six expert panels, the operational discharge plan, including three areas of patientempowerment, telephone follow-up and home visit, was designed, implemented for three monthsand evaluated for 23 patients. European Heart Failure Self-Care Behavior Scale and informationregistration form to record the number of hospitalization and length of hospital stay were used tocollect the quantitative data. The nonparametric Wilcoxon test was used to analyze the data by SPSS16. Qualitative participatory evaluation was performed during a group discussion and analyzed basedon qualitative content analysis method with conventional approach p Results: Considering the solutions provided by the participants, the operational discharge plan wasdesigned and implemented with the cooperation of relevant stakeholders. Evaluation showed significanteffects of designed discharge plan on selfcare behavior (p 0.001), number of hospitalizations (p 0.001),and length of hospital stay (p 0.001).Conclusion: Changes were made to improve the heart failure patients’ discharge plan using actionresearch, which resulted in reduced rehospitalization and improved selfcare behavior.