Since starting the program, the Heart Failure Resource Center (HFRC) NPs have seen nearly 400 patients in the clinic. They receive six to ten new patients a week.
Heart failure patients treated in the HFRC experience lower readmission rates than other patients. Hospital readmission 30 days after discharge for heart failure patients (DRG 127) treated by HFRC was 1.6 percent for fiscal year 2007, 75 percent lower than for heart failure patients not in the program. The national average for readmission 30 days after discharge for DRG 127 patients is 20 percent.
Hospital readmission 90 days after discharge for heart failure patients treated by HFRC was 2.9 percent, compared to 10.4 percent for heart failure patients not in the program.
The HFRC functions as an outpatient service of the hospital and is considered a cost neutral benefit for patients as the hospital has chosen to accept payment from payers and not pursue balances. The program uses a cost avoidance model, identifying reduction in heart failure admissions and re-admissions as a way to help cover the cost of the program.
As stated in the above section, the HFRC program has reduced hospital readmissions within 30 days and 90 days of discharge for heart failure patients.
In fiscal year 2007, 85 percent of HFRC patients were on ace-inhibitor or angiotensin receptor antagonist therapy. Of these patients, 65 percent had their therapy optimized (i.e. the best possible dose for that patient). Of patients not on therapy, 12 percent were determined to be intolerant to the medication therapy.
Ninety-six percent of HCRF patients were on Beta-blocker therapy. Of these patients, 56 percent had their therapy optimized (i.e. the best possible dose for that patient). Of patients not on Beta-blocker medication, three percent were determined to be intolerant to the medication therapy.
Anecdotally, nurses working in the HFRC are very satisfied with their ability to work to the full capacity of their licensure and to develop and deploy their expertise with heart failure. In addition, the program saves nurses the unproductive time of traveling to patient visits in outlying communities. Currently, Fuqua’s nurse turnover rate for the HFRC is zero.
100 percent of patients responding to surveys about the telemanagement program rated the program as excellent or good. The patient satisfaction scores for the clinic are consistently statistically higher than many of the other outpatient services and the survey vendor’s comparison group. Anecdotal notes praise the attention to needs, ease in accessibility to clinicians, and perception that the patient comes first.
