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SundayShoes300A team at Preston Memorial Hospital, in Kingwood, W.Va., developed a simple solution to help heart failure patients monitor weight gain and determine when to contact their providers for assistance. The innovative Sunday Shoes Program utilizes a personal possession that nearly all of the 25-bed hospital's heart patients already own -- dress shoes or "Sunday shoes."

In 2012, Preston Memorial's heart failure readmission rate topped 22.6 percent. Distressed patients were returning to the emergency department presenting with significant weight gain of which they were virtually unaware. Interviews with readmitted patients revealed serious health literacy and resource deficiencies that prevented the patients from realizing they were gaining excess fluid. Many did not have a scale at home, and they did not understand the severity of their condition.

So, the team turned to an unconventional tool that their patients did have at home, snug-fitting dress shoes.  Clinicians used teach back techniques to help patients learn how to detect pedal edema using the fit of their Sunday shoes as a gauge. Patients were taught to try on their shoes each morning and to call their providers any morning that their shoes did not fit to receive instructions.

Following implementation of the Sunday Shoes Program, Preston Memorial's 30-day readmission rate for heart failure dropped to 0 percent in 2013 and 2014.

For a more detailed description of the Sunday Shoes Program, click here.

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