Viven Health - Heart Failure Readmission Program for Hospitals

Heart Failure Readmission Program for Hospitals

Overview

This program supports patients discharged from the hospital with heart failure during the critical first 30 days after discharge, when the risk of readmission is highest. Through simple, real-life examples and everyday decision moments, discharged patients learn how to monitor symptoms, follow daily care routines, and take early action when changes occur. The goal is to help patients stay stable at home, avoid complications, and reduce the likelihood of returning to the hospital.

Early change recognition: Discharged patients learn to identify early signs of worsening heart failure—such as rapid weight gain, swelling, increased shortness of breath, or fatigue, and understand when to act
Daily stability habits: Clear, practical guidance on medications, fluid and sodium management, activity, and self-monitoring that support recovery throughout the first 30 days
Timely communication: Patients practice knowing when and how to contact their care team early so concerns can be addressed before they become urgent

Core Prevention Skills — Heart Failure Readmission Prevention

Recognize early signs of worsening heart failure (weight gain, swelling, shortness of breath, fatigue)
Understand daily self-monitoring and symptom tracking expectations
Apply medication, fluid, and sodium management strategies as directed
Support safe activity and energy-conservation techniques during recovery
Communicate changes early to the care team to prevent avoidable readmissions

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