Table 29

Recommendations for Hospital Discharge

Recommendations or IndicationsCORLOEReferences
Performance improvement systems in the hospital and early postdischarge outpatient setting to identify HF for GDMTIB82,365,706,792–796
Before hospital discharge, at the first postdischarge visit, and in subsequent follow-up visits, the following should be addressed:
  • a. initiation of GDMT if not done or contraindicated;

  • b. causes of HF, barriers to care, and limitations in support;

  • c. assessment of volume status and blood pressure with adjustment of HF therapy;

  • d. optimization of chronic oral HF therapy;

  • e. renal function and electrolytes;

  • f. management of comorbid conditions;

  • g. HF education, self-care, emergency plans, and adherence; and

  • h. palliative or hospice care

IB204,795,797–799
Multidisciplinary HF disease-management programs for patients at high risk for hospital readmission are recommendedIB82,800–802
A follow-up visit within 7 to 14 d and/or a telephone follow-up within 3 d of hospital discharge are reasonableIIaB101,803
Use of clinical risk-prediction tools and/or biomarkers to identify higher-risk patients are reasonableIIaB215

COR indicates Class of Recommendation; GDMT, guideline-directed medical therapy; HF, heart failure; and LOE, Level of Evidence.