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Reducing CHF Admissions /Readmissions in a Small Hospital Setting Marilyn Burwitz, RN

Reducing CHF Admissions /Readmissions in a Small Hospital Setting Marilyn Burwitz, RN. The Impact of Congestive Heart Failure. 5.2 million people affected in the US 400,000 new cases diagnosed each year Responsible for 870,000 hospital admissions per year 200,000 people die of CHF each year

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Reducing CHF Admissions /Readmissions in a Small Hospital Setting Marilyn Burwitz, RN

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  1. Reducing CHF Admissions /Readmissions in a Small Hospital SettingMarilyn Burwitz, RN

  2. The Impact of Congestive Heart Failure • 5.2 million people affected in the US • 400,000 new cases diagnosed each year • Responsible for 870,000 hospital admissions per year • 200,000 people die of CHF each year • $38.1 billion annually (predicted to rise to $44.6 billion by 2015) Family Practice Notebook (http://www.fpnotebook.com/) • What can we do?

  3. Goals • Educate participants (and their caregivers) concerning their disease process • Decrease admission/readmissions to the hospital • Optimize medical therapy • Have 100% of inpatients with a diagnosis of CHF referred post-hospitalization • Equip participants with the necessary tools to maintain and possibly improve their personal level of optimal health.

  4. Our Model • Combination of education and exercise • Six weeks program on a revolving basis • All participants in the program must be under the care of a primary care provider. • Optimization of medical therapy is under the direction of each individual provider. • A progress report is sent to the PCP after the initial visit, midway through the program and again at discharge. • $25 participant charge for the program

  5. Before Getting Started • Baseline EKG (if not done in the past 2 weeks) with further work-up if ectopy is noted • Pre-entry labwork (if not done within the past 90 days) -CMP, CBC, BNP • Echocardiogram (if not done within one year prior to admission)

  6. Managing a Chronic Disease • We can’t expect patients to manage chronic conditions such as congestive heart failure without giving them the tools to do so. • Equipping them with knowledge gives them the ability to actively participate in their own care.

  7. Education: The Key to Success • Medical Terms and Cardiac Anatomy • CHF: What is it? • CHF Management • Sodium and Fluid • Reading Nutrition Labels • Monitoring Your Weight • Medications • The Importance of Exercise • Signs/Symptoms of Exacerbation • Tests and Interventions • Sudden Heart Failure • End-of-Life Decisions and Care

  8. Plan • Track admissions and readmissions for CHF exacerbations for one year following completion of the program • Ongoing outcome data will be shared with the Medical Staff and the PI Committee

  9. Thus Far… StartFinish • MET levels 1.5 -2.5 2.0-2.9 • Exercise Time 17-23 minutes 35-37 minutes • 100% of participants reported a positive improvement in their confidence level.

  10. Questions?

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