2025 Southeastern Residency Conference

Title: Evaluating CPP Impact to Ensure GDMT, Improve Heart Failure Patient Outcomes, and Reduce Readmissions


Authors: Allison D. Johnson; Kathy Davari; Mary K. Pounders


Background: The prevalence of heart failure (HF) is increasing annually with approximately 6.7 million American adults age 20 or older currently affected. The cost of HF in 2012 was estimated to be $30.7 billion. Previous studies have highlighted the role that clinical pharmacists can play in improving hospital readmission rates for patients with HF. The Atlanta VA Health Care System has a procedure in place for clinical pharmacist practitioners (CPP) to assess patients recently discharged from the hospital after a HF exacerbation. Patients are identified using a dashboard that lists any patient recently discharged with an exacerbation. This project aims to evaluate the efficacy of the Atlanta VA CPP interventions related to preventing readmissions for HF patients. A focus will be placed on interventions with Guideline Directed Medical Therapy (GDMT) agents.


Methods: This project is a retrospective quality improvement project comparing readmission rates and prescribing rates of GDMT agents of patients assessed by a CPP within 10 days of a HF exacerbation hospital discharge compared to patients without CPP assessment. For this project, a readmission is defined as a hospitalization within 30 days of initial discharge for a HF exacerbation. Patients that receive care from the Atlanta VA who have a diagnosis of HF during the year 2023 and the year 2024 were identified from the VA electronic health record. Fifty patients with a HF hospitalization in the year 2023 were randomly selected to evaluate their readmission rates and GDMT agents. Fifty patients with HF hospitalization in the year 2024 were randomly selected to evaluate their readmission rates and GDMT agents following CPP intervention. Data collection points will include, but are not limited to, age, gender, time of hospitalization, GDMT medications before and after hospitalization, GDMT agents after CPP assessment, patient readmission, primary care provider or clinic, and CPP who assessed the patient. Data will be recorded without patient identifiers and will be maintained confidentially. Upon review of the data, the impact of CPP’s assessment on patients with a hospitalization for HF exacerbation will be assessed.


Results: In progress


Conclusions: In progress