The Impact of Hospital Readmission Reduction Program (HRRP) on heart Failure Patients in King Khalid Al-Kharj Hospital - KSA: A Quality Improvement Project

Abstract

Background

Heart failure (HF) remains a global epidemic associated with poor prognosis, high morbidity, and significant healthcare costs. In Saudi Arabia, approximately 320,000 HF patients contribute to a growing disease burden, with annual healthcare expenditures reaching $1.92 billion. Hospital readmissions, particularly within 30 days, continue to challenge healthcare systems, prompting initiatives like the U.S. Hospital Readmission Reduction Program (HRRP) to enhance discharge planning and continuity of care.

Objective

This study aims to assess the impact of a structured, multidisciplinary heart failure care program at King Khalid Hospital, Al-Kharj, on 30-day readmission rates, inpatient mortality, and average length of stay (LOS) among HF patients.

Methods

We employed a quasi-experimental pre–post interventional design at King Khalid Hospital. The intervention integrates evidence-based HF management pathways, early post-discharge follow-up through physical and virtual clinics, multidisciplinary inpatient rounds, structured discharge planning, and collaboration with home healthcare services. The study compares outcomes from a 12-month pre-implementation phase to a 12-month post-implementation phase. Data were collected retrospectively and prospectively through electronic medical records and verified by the hospital’s quality improvement team.

Outcomes Measured

Primary outcomes include 30-day readmission rates. Secondary outcomes encompass inpatient mortality, LOS, and predictos of rehospitalization and non-compliance. The targeted reduction for 30-day readmissions is to reach 13%, with a 50% decrease in HF mortality and a 10% reduction in LOS compared to baseline.

Expected Impact

This initiative seeks to bridge the gap between clinical practice and guideline-based care, improve patient outcomes without increasing resource use, and serve as a replicable model for HF management programs within the Kingdom of Saudi Arabia and beyond