New Research Explores Success of ACC’s Patient Navigator Program New research exploring the benefits and best practices of ACC's Patient Navigator Program was presented during both ACC.17 and NCDR.17. While more data are needed to truly estimate the precise level of benefit of the Patient Navigator Program, the results are encouraging, particularly in the areas of heart failure (HF) education processes, post-discharge phone calls, scheduled follow-up appointments and readmission rates. Highlights include: Standardizing HF Education and Documentation Results from a study led by Marit S. Planton, BSN, et al., at St. Vincent's Medical Center (SVMC) in Bridgeport, CT, found that the ACC Patient Navigator Program helped to successfully identify opportunities for improvement in the HF education process, reduce readmission rates, improve patientsf understanding of HF and encourage compliance among staff. Over the course of 11 months. From January to November 2016. SVMC saw its HF education documentation process improve by 112.5 percent, from 32 percent to 68 percent. SVMC plans to expand the new education process to all inpatient hospital units in order to include HF patients who may be in non-cardiac units. Establishing the P.U.M.P Club Successful HF readmission reduction at Saint Maryfs Hospital in Waterbury, CT, demonstrated the effect working across institutional silos has on patient outcomes. A study led by Paul Kelly, MD, FACC, et al., found that both short-term and long-term readmission rates declined after establishing its P.U.M.P Club. By creating a multidisciplinary team, holding standardized weekly meetings to review all HF patients and using cardiovascular rehab and pet therapy with patients, the total number of patients readmitted within 150 days of hospital discharge declined from 48 to 31. Moving forward, Saint Mary's Hospital aims to expand the program and standardize methods across its five-hospital regional health system. Reducing Hospital Readmissions For AMI and HF Patients According to a study led by Camille Randol, RN, Jamal M. Brewster, RN, and Richard E. Shaw, PhD, FACC, ACCfs Patient Navigator Program and ACCfs ACTION Registry-GWTG contributed to the reduction of 30-day readmission rates in acute myocardial infarction (AMI) and HF patients between 2014 and 2016. The 30-day readmission rates for AMI patients at the California Pacific Medical Center in San Francisco, CA, dropped from 12 percent to 8.7 percent, while rates for HF patients dropped by 1.5 percent total. Other results include a 39 percent increase in seven-day follow-up and 82 percent increase in nursing teach back. Expanding Post-Discharge Phone Calls Resources from ACC's Patient Navigator Program helped the University of Utah Hospital and Clinics (UUHC) successfully achieve its goal of improving the number of post-discharge phone calls made, according to a study led by Dawn Young, BSN, et al. Through the program, UUHC monitored its progress and made adjustments to its processes over the course of a year. The number of phone calls made within 48 hours increased by 57.1 percent, from less than 5 percent in January 2016 to an average of 61 percent by December 2016. Eliminating Barriers to Follow-Up Appointments Scheduled seven-day follow-up appointments are important for HF patients, but they do not guarantee attendance, according to a study led by Lisa Casher, RN. After noticing a drop in attendance at Mercy Hospital in Portland, ME, Casher aimed to help determine the most common barriers HF patients face. The results found that 46 percent of discharged HF patients were unable to attend their follow-up appointments due to lack of affordable, accessible and reliable transportation. By establishing a source of transportation prior to discharging HF patients, Mercy Hospital increased attendance from 75 percent in Q1 2016 to 86 percent in Q4 2016. Teaming Up to Improve Care By applying ACC's Patient Navigator Program, hospitals may successfully reduce the readmission rate among primary HF patients, according to results from Montefiore Medical Center. A Navigator Team. Including a nurse and a pharmacist . Provided education, scheduled follow-up and medical therapy recommendations to 51 HF patients from June 2015 to January 2016. Results showed that this patienttailored approach decreased readmission rates by 81. 3 percent, from 25.6 percent to 4.8 percent. In addition, the Patient Navigator Program significantly increased the education available and follow-up offered to patients. "We are excited to see how our data, especially the early post-discharge appointment, were adopted by the Hospital Readmissions Reduction program at Montefiore Medical Center, across all three campuses in the Bronx,h said Katherine DiPalo, PharmD, et al. Managing CV Risk in Patients With Type 2 Diabetes Cardiologists are treating more and more patients with established cardiovascular disease and diabetes. Diabetes, particularly type 2 diabetes, is common in patients with an array of cardiovascular disorders including coronary artery disease, peripheral vascular disease, congestive heart failure and stroke.Over the last decade, studies have shown that patients with diabetes are at greater risk of dying from these cardiovascular diseases than those without diabetes. Several important randomized trials (i.e., EMPA-REG OUTCOME, SUSTAIN-6 and LEADER) show medical interventions in cardiovascular patients with diabetes can provide protective benefits. Deciphering the findings from these trials was a key component of an ACC.17 session chaired by Christopher Cannon, MD, FACC. The session also offered a closer look at the new therapies and included robust discussion and debate on the cardiologist’s role in managing cardiovascular risk in their diabetic patients. According to Nathan D. Wong, PhD, FACC, it is critical going forward that cardiologists employ a team-based approach in collaborating with endocrinologists and other providers managing patients with diabetes. As part of ongoing efforts in this area, the ACC, with support from Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly and Company, is working to raise awareness and prepare the cardiology community for the coming paradigm shift. Leveraging data from the Diabetes Collaborative Registry, the ACC will identify and capture key learnings from cardiovascular innovators who are managing cardiovascular risk reduction for people with type 2 diabetes.These learnings will be communicated to the wider cardiology community and used to help develop clinician and patient tools.
Published by American College of Cardiology. View All Articles.
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