June 26, 2012

Heart failure program helps patients transition from hospital to home

COLUMBIA, Tenn. – Heart failure management and the transition from hospital to home are receiving increasing focus by the medical community. Vanderbilt Heart and Maury Regional Medical Center (MRMC) recently teamed up to introduce a new program to ensure that transition is a safer one for their patients. While such programs exist in association with large tertiary referral hospitals in Nashville, such as Vanderbilt and St. Thomas Hospitals, comprehensive heart failure management has previously been unavailable for patients outside of the city. More than 300 patients were admitted with heart failure to MRMC last year. The Heart Failure Society of America currently recommends referral to a heart failure program for any patient with an admission for heart failure, as well as those with comorbidities such as diabetes and COPD, as even a single admission increases the risk of death and/or cardiovascular morbidity over the follow-up period. 

“One of our goals with the heart failure program is to ensure early follow-up for all patients within seven days of hospital discharge. Patients have long medication lists, and despite best efforts, medication errors and lack of insight into heart failure are common at the first follow-up visit. Expeditious adjustment of medications helps avoid readmission as well as improve quality of life and survival,” said MRMC Clinical Outcomes Director Brenda Hogan.

The heart failure clinic at MRMC opened in April under the direction of Dr. Rebecca Hung, a cardiovascular specialist with Vanderbilt Heart. Dr. Hung, a graduate of Harvard Medical School, trained in heart failure and cardiac transplantation at Massachusetts General Hospital in Boston. She was recruited by Vanderbilt for its heart transplant/heart failure program in 2005.

“The clinic’s level of involvement can range from a one-time visit for medication reconciliation and additional education to a more intensive medication regimen and frequent interval follow-ups, up to referral for cardiac transplantation and assistance with end of life issues,” said Dr. Hung. “Our interaction is individualized with the patient and his or her provider and caregiver.”

“All patients participating in the program receive phone follow-ups prior to their next office visit to ensure they are correctly responding to their medication changes,” said Hogan. “The program provides patients with a means to seek early intervention rather than waiting until symptoms become intolerable and require hospital admission.”

Hogan said the Vanderbilt Heart – Columbia/MRMC program has already provided important insight into post-operative problems which can be minimized through better patient education and follow-up. Among those, medication errors are most common, with 43 percent of patients not taking medications as listed on the hospital discharge list and 42 percent confused by directions pertaining to salt and fluid intake.

“Heart failure is a growing epidemic that requires a dynamic response system. We, with Vanderbilt Heart at Maury Regional, look forward to working with our colleagues in Columbia in tackling these health care challenges,” said Dr. Hung.

Dr. Hung will be the featured speaker at the June 28 meeting of the MRMC Healthy Hearts Education Group. The group will meet at 6 p.m. in the William R. Walter Educational Conference Center at the MRMC Annex at 1223 ½ Trotwood Avenue in Columbia. There is no charge to attend the meeting which is open to the public. More information may be obtained by calling 381.1111, Ext. 4343.