At North Shore-LIJ Health System, systemwide research indicated patient follow-ups might reduce the high readmission rate shortly after discharge of heart failure patients. Encouraged by the data, Forest Hills Hospitals Congestive Heart Failure Task Force comprised of medical and cardiology directors; managers from nutrition, quality assurance and education; and ED, recovery room and floor nurses swung into action.
The research disclosed general nursing downtime from 8 to 9 a.m. in the recovery room and when OR procedures are canceled or rescheduled. During the downtime, recovery room nurses volunteered to place follow-up phone calls to recently released heart failure patients because they were already callback trained with their surgery patients. They listen … pick up signs and symptoms and are very comfortable dealing with emergency situations and critically ill patients, said Rita Mercieca, RN, associate executive director of nursing.
When once-a-week post discharge calls to patients with myocardial infarctions were initiated for six weeks, their readmission rates dropped from 32% in June 2009 to 14% in December 2009.Forest Hills Hospitals Congestive Heart Failure Task Force is comprised of medical and cardiology directors; managers from nutrition, quality assurance, and education; and ED, recovery room and floor nurses.
About 45 to 60 follow-up calls are placed each week, with each call taking about 10 to 20 minutes. The nurses assess the patients status and pose questions about weight gain, ankle swelling, sleep routine, medication compliance and diet maintenance.
The nurses also address common problems with patients, such as continuing with old medication, which may not be effective, or the tendency to not take medicine when they feel better. The simple follow-up call allows the nurses to help patients get timely care. The calls establish a really good communication link to the patients and service to the community, Mercieca said. So its continuing care while reducing the readmission rate.
Because of the initiative, the health system received the National Quality Forums 2010 Healthcare Award for superior delivery of services and patient satisfaction increased.