| Course | HLTH 4913 Senior Capstone Experience: Healthcare Administration |
|---|---|
| Module | Module 2 |
| Paper type | Capstone literature review |
| Length | 1,160 words, about 4 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | B.S. in Healthcare Administration |
| Updated | September 2026 |
Free sample paper for HLTH 4913 Module 2
Rides Alone Did Not Fill the Chairs: A Capstone Literature Review on Early Follow-Up, Transitional Care and Transportation After Heart Failure Discharge
Student Name
American College of Education
HLTH4913: Senior Capstone Experience: Healthcare Administration
Module 2 Assignment
Instructor Name
October 12, 2026
Purpose and Approach
The capstone proposal identified a gap at a composite 240-bed community hospital: only 41% of patients discharged home after heart failure are seen within seven days, and transportation is the barrier they name most often. This review asks what the published evidence says about three questions. Does early follow-up matter? Which transitional care interventions reduce readmissions for heart failure? And does solving transportation, by itself, get patients to their appointments?
The search ran in PubMed and CINAHL, pairing heart failure with terms for transitional care, follow-up, readmission and transportation, limited to English-language studies of U.S. or comparable health systems, with preference for systematic reviews, meta-analyses and randomized trials. Reference lists of the key reviews were checked for additional studies. The review is organized by question rather than by source, so that the evidence on each point can be weighed together.
Does Early Follow-Up Matter?
The most cited evidence comes from Hernandez et al. (2010), who analyzed 30,136 Medicare patients aged 65 and older discharged home after heart failure hospitalization from 225 hospitals in national quality improvement registries. Hospitals differed widely in how many of these patients were seen within a week, the middle hospital managing just over a third. Ranked into four groups by that rate, the lowest group's patients were readmitted within 30 days noticeably more often than patients in each of the other three, and the gap held after adjusting for patient risk.
Two cautions apply. The study was observational, so hospitals that saw more patients early may also have had better discharge planning or stronger outpatient networks behind them. And the benefit leveled off: the second quartile did about as well as the fourth. The finding supports early follow-up as a marker of a well-functioning transition system rather than as a single cause, which matters for how the capstone frames its goal.
What Transitional Care Works?
Two meta-analyses of randomized trials give a clearer answer about interventions. Feltner et al. (2014) pooled 47 randomized trials of care designed to carry heart failure patients safely from hospital to home. Over three to six months, programs that sent clinicians to patients' homes and specialized clinics staffed by heart failure teams both cut readmissions for any cause, with high strength of evidence, and both, along with structured telephone support, reduced mortality. Scheduled calls from clinicians, known as structured telephone support, lowered readmissions for heart failure itself, though not readmissions for every cause. Telemonitoring and primarily educational interventions did not reduce readmissions or mortality. Few trials reported 30-day outcomes, the measure the federal penalty uses.
Van Spall et al. (2017) reached compatible conclusions in a network meta-analysis of 53 trials with 12,356 patients. Nurse home visits, nurse case management and disease management clinics all reduced all-cause readmissions, with nurse home visits showing the largest pooled cost savings, and telephone, telemonitoring, pharmacist and education interventions did not significantly improve outcomes. The interventions that work are the ones that bring a clinician to the patient or bring the patient reliably to a clinic built for them.
How Much Does Transportation Matter?
Syed et al. (2013) systematically reviewed 61 U.S. studies of transportation barriers to ongoing primary and chronic disease care. Their judgment was that lacking a way to get to care is a real and common obstacle, weighing most on people with low incomes and those with little or no insurance, leading to missed or rescheduled appointments, delayed care and missed medications. They also noted wide variation in how studies measured transportation barriers and a lack of research on whether interventions to remove them improve clinically meaningful outcomes. The review supports the hospital's finding that patients cite transportation, but it cautions against assuming that transportation is the only barrier or that removing it will be enough.
Do Free Rides Reduce Missed Visits?
The most direct test is a trial by Chaiyachati et al. (2018), who offered free rideshare trips to 786 Medicaid patients with primary care appointments at two academic practices in West Philadelphia, allocating them to the offer or usual care by appointment day. Uptake was low: only 26% of those in the intervention arm who answered the reminder call used a ride. The missed appointment rate was 36.5% with the ride offer and 36.7% without it, a difference of essentially zero.
The trial studied routine primary care, not the week after a heart failure hospitalization, when patients may be sicker and more motivated, and it offered rides by phone two days before the visit rather than arranging them at discharge. Still, it is a warning. Patients who say they lack transportation may also lack reminders, understanding of why the visit matters, energy after hospitalization or a caregiver to go with them, and a ride addresses only one of those.
Could a Video Visit Replace the Trip?
If travel is the barrier, one option is to remove the trip rather than provide a ride. The trial evidence gives mixed guidance here. Both meta-analyses found that telemonitoring, in which patients transmit weights or symptoms for remote review, did not reduce readmissions or deaths, and that education alone did not either. Structured telephone support, regular scheduled calls from clinicians, reduced heart failure admissions in Feltner and colleagues' review, though not admissions for all causes, and Van Spall and colleagues did not find a significant benefit from telephone interventions. A seven-day visit by video is not the same as either model; it is a real clinician visit that happens to be remote, and neither review tested it directly. For the capstone, the evidence supports offering a video visit to patients who cannot travel as a way of keeping the clinical contact, but it does not support treating remote monitoring as a substitute for the visit. The physical examination that a home visit or clinic provides, including weight, swelling and blood pressure checked by a clinician, remains the component the strongest trials share.
Synthesis and Gaps
Read together, the literature points in a consistent direction. Early follow-up is associated with fewer readmissions, and the transitional care models proven in trials, home visits, nurse case management and heart failure clinics, all make contact reliable after discharge. Transportation is a real barrier, but the best available trial suggests that offering rides alone does not change attendance. The implication for the capstone is that transportation should be solved as part of a transitional care model, arranged before the patient leaves the hospital and paired with a clinician contact, rather than as a stand-alone service.
The literature also leaves gaps the capstone must acknowledge. No trial found in this review tested transportation arranged at discharge specifically for heart failure follow-up. Few trials report 30-day readmissions. And most transitional care trials ran in university hospitals staffed with research nurses, so a community hospital must plan for more modest effects and measure its own results carefully.
References
Chaiyachati, K. H., Hubbard, R. A., Yeager, A., Mugo, B., Lopez, S., Asch, E., Shi, C., Shea, J. A., Rosin, R., & Grande, D. (2018). Association of rideshare-based transportation services and missed primary care appointments: A clinical trial. JAMA Internal Medicine, 178(3), 383-389. https://doi.org/10.1001/jamainternmed.2017.8336
Feltner, C., Jones, C. D., Cené, C. W., Zheng, Z.-J., Sueta, C. A., Coker-Schwimmer, E. J. L., Arvanitis, M., Lohr, K. N., Middleton, J. C., & Jonas, D. E. (2014). Transitional care interventions to prevent readmissions for persons with heart failure: A systematic review and meta-analysis. Annals of Internal Medicine, 160(11), 774-784. https://doi.org/10.7326/M14-0083
Hernandez, A. F., Greiner, M. A., Fonarow, G. C., Hammill, B. G., Heidenreich, P. A., Yancy, C. W., Peterson, E. D., & Curtis, L. H. (2010). Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA, 303(17), 1716-1722. https://doi.org/10.1001/jama.2010.533
Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: Transportation barriers to health care access. Journal of Community Health, 38(5), 976-993. https://doi.org/10.1007/s10900-013-9681-1
Van Spall, H. G. C., Rahman, T., Mytton, O., Ramasundarahettige, C., Ibrahim, Q., Kabali, C., Coppens, M., Haynes, R. B., & Connolly, S. (2017). Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: A systematic review and network meta-analysis. European Journal of Heart Failure, 19(11), 1427-1443. https://doi.org/10.1002/ejhf.765
The HLTH 4913 Module 2 assignment instructions
HLTH 4913 Module 2 commonly asks you to review the literature on the problem you proposed in Module 1. Prompts usually ask you to describe how you searched, select the most relevant and credible sources, summarize and compare their findings, and explain what the evidence means for your capstone. Many sections set a minimum number of peer-reviewed sources, often five to ten from the past ten years, and some ask you to include at least one systematic review or meta-analysis. Graders expect a synthesis organized by theme, not a list of article summaries. Include evidence that challenges your initial assumptions as well as evidence that supports them, and check Canvas for whether a literature matrix must be attached and how many sources it should hold.
How this HLTH 4913 Module 2 example is built
The sample starts by restating the capstone problem, posing three questions and describing the search. Each question then gets its own section. The first reports a large observational study and interprets its limits. The second compares two meta-analyses of randomized trials and draws out where they agree. The third uses a systematic review to confirm that transportation is a barrier while noting the evidence gap on interventions. The fourth summarizes a rideshare trial whose null result challenges the capstone's first assumption. The synthesis states what the evidence supports and how it redirects the project, then names three gaps that limit confidence for a community hospital.
Where the points sit in the HLTH 4913 Module 2 rubric
Capstone literature review rubrics typically reward relevance and quality of sources, accurate summary, synthesis across sources and application to the project. Graders look for peer-reviewed studies, with systematic reviews and trials weighted more heavily than opinion pieces. Accurate reporting of designs and results earns points, and misreporting a study's finding costs them. The synthesis criterion carries heavy weight: it rewards comparing sources and drawing conclusions across them. Application to the capstone, including how the evidence changes the plan, is often its own criterion. Identifying gaps shows critical thinking. Organization by theme and APA 7 formatting finish the rubric, and a short literature matrix, where required, lets graders check sources quickly.
Common HLTH 4913 Module 2 mistakes, and how to avoid them
Capstone reviews most often lose points by summarizing one article per paragraph with no comparison, which leaves the reader to do the synthesis. Another common problem is including only evidence that supports the planned solution; a study with a null result, handled well, shows maturity. Students also report findings without designs or sample sizes, hiding how strong the evidence is. Organize by question. Report key numbers accurately. End with what the evidence means for your capstone. If your capstone concerns staffing, denials or patient experience, share your Module 1 proposal and the rubric, and a Module 2 review can be written to match.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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HLTH 4913 Module 2 questions, answered
What does HLTH4913 Module 2 usually ask for?
The second HLTH4913 module often asks for a literature review on your capstone problem: a described search, a synthesis of the most relevant studies organized by theme, and an explanation of what the evidence means for your project and where it falls short. Your classroom's instructions decide the number of sources.
Which transitional care interventions reduce heart failure readmissions?
Meta-analyses of trials found that nurse home visits, nurse case management and multidisciplinary heart failure clinics reduced all-cause readmissions, while telemonitoring and education alone did not.
Do free rides reduce missed appointments?
In one trial of Medicaid primary care patients, offering free rideshare trips did not change the missed appointment rate, partly because few patients used the rides.
Where can I find a free HLTH 4913 Module 2 sample paper?
It is available in full on this page: the Module 2 capstone literature review on follow-up after heart failure discharge, transitional care meta-analyses, transportation barriers and a rideshare trial, with synthesis and gaps.
How should a capstone literature review be organized?
By question or theme rather than by article, so that studies on the same point are compared and the review ends with what the evidence means for the project.