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Successful Management of Heart Failure Patients: Multidisciplinary Approach to Reducing Readmissions
Healthcare Intelligence Network, Oct 2007, Pages: 23
Approximately 5 million people in the United States have heart failure, with 550,000 new cases diagnosed annually. The condition is the number one cause for hospitalization among the elderly; one fifth of all hospitalizations have a primary or secondary diagnosis of heart failure.
In response, magnet hospital Hackensack University Medical Center (HUMC) has launched a dedicated inpatient heart failure unit that is dramatically reducing readmission rates in this population. This special report, 'Successful Management of Heart Failure Patients: Multidisciplinary Approach to Reducing Readmissions,' chronicles the evolution and operation of the three-year-old unit and its foundation in continuous care and patient education and self-management.
In this 23-page report, the team's education coordinator and administrative manager—both cardiac nurses—describe how the team is overcoming barriers to effective heart failure management.
Contributing authors Michele Gilbert, education coordinator of the heart failure team, and Lenore Blank, administrative manager, share some of the workings of the team, including:
- Addressing comorbidities, medication reconciliation, diet, psychosocial concerns and financial and physical limitations often faced by heart failure patients;
- Applying continuous care strategies to improve the quality of emergency room, inpatient, outpatient and home care of heart failure patients;
- Fostering patient education and self-management through improved discharge instructions, home visits, telephone follow-up and support groups;
- Developing admission and exclusion criteria for the heart failure unit;
- Educating and training multidisciplinary team members;
- Building partnerships with other heart failure nurses and subacute facilities to improve care for heart failure patients and much more.
The HUMC dedicated heart failure unit received a grant from Pursuing Perfection: Raising the Bar for Health Care Performance, a $21 million initiative sponsored by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI), an internationally recognized leader in healthcare quality.
This report is based on a 2007 audio conference on pursuing perfect care for the chronically ill by focusing on the whole patient.
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