Heart-Failure Clinics Help Curb Hospital Readmission Rates
Nearly 30 percent of heart-failure patients are re-hospitalized within 60 to 90 days of discharge, according to a 2013 study by the Journal of the American College of Cardiology (JACC).
Anuj Jain, MD, of the Nebraska Heart Institute (NHI) in Lincoln, said a major issue is patient uncertainty in following instructions after discharge. Heart-failure patients may not realize that seemingly harmless actions, like drinking too much water, can result in rehospitalization.
“We can’t just assume that the patient knows what to do,” said Dr. Jain, an interventional/advanced heart failure cardiologist at Nebraska Heart Institute.
Jeffrey Carstens, MD, an interventional cardiologist for CHI Health in Omaha, said reinforcing care instructions to patients is critical.
“We try to see all heart-failure patients in the office within about 72 hours of their initial hospitalization,” said Dr. Carstens. “It’s helpful to answer questions, make sure they understand their medications, and determine if we need to make adjustments.”
Dr. Jain said that at NHI and CHI Health St. Elizabeth in Lincoln, the heart-failure clinic team reduced readmission rates significantly since assembling 18 months ago.
CHI Health Creighton University Medical Center - Bergan Mercy has had a similar heart-failure clinic for nearly 10 years.
Dr. Carstens said heart-failure patients who aren’t referred for follow-up care are roughly twice as likely to be readmitted 30 days after dismissal.
“These are fairly complex patients,” said Dr. Carstens. “Typically, they have multiple problems and managing heart failure itself is rather difficult.”
Heart-failure patient Karen Stanley, 75, of Lincoln, experienced complications related to diabetes and fluid retention after being hospitalized more than two years ago.
“Everyone who treated me at NHI and St. Elizabeth was incredibly on top of the domino effect I was experiencing,” said Stanley. “It saves me having to go to the emergency room or hospital because I can do so much monitoring by phone.”
The CUMC - Bergan Mercy heart-failure clinic emphasized collaboration and continuity of care.
“Heart failure is a chronic condition that requires active, ongoing management,” said Dr. Carstens. “Whatever the situation is or the concern might be, the patient knows we’re only a phone call away.”