Advanced Practice Nurse-managed Heart Failure Clinic Benefits Patient’s Quality of Life and Limits Readmissions

Christina Hanson, Msn, Acns-Bc,Donna J Plonczynski, Phd, Aprn, Fnp-Bc,Kara Aalfs, Msn, Acns-Bc

doi:10.13189/nh.2013.010301

Abstract

Background: Heart failure (HF) is the primary cause of hospitalizations and readmissions to a hospital within 30 days of initial discharge. In 2010 HF cost an estimated $39.2 billion in health care services, lost productivity and medications. Optimizing outpatient care is vital to effectively manage this patient population. Objective: The purpose of this paper is to describe and evaluate the effectiveness of an optimized outpatient HF clinic. Patient outcomes from a Midwestern community hospital were based on quality of life (QOL) and readmission rates. Methods: A retrospective chart audit was conducted on a random sample of patients enrolled in the Heart Failure Recovery Center (HFRC). The QOL outcomes were measured using the Minnesota Living with Heart Failure® Questionnaire. Results: Enrolled patients demonstrated improvement in their QOL in the emotional, physical, and overall scores across the first 6 months of care. In addition, there were significantly fewer 30-day all-cause readmissions when compared to non-Clinic patients. Conclusion: Utilization of an APN-managed multidisciplinary HF clinic improved patient's QOL and contributed to one hospital's decreased all-cause readmission rates for the HF population.

Highlights

Heart failure (HF) is the primary cause of hospitalizations and readmissions to a hospital within 30 days of initial discharge
The Heart Failure Recovery Center (HFRC) is an outpatient Clinic located in the Northwest suburbs of Chicago within a 250-bed community-hospital
This paper identifies significant improvements in the HF patient’s quality of life (QOL) overall and within the physical and emotional dimensions

Summary

Introduction

Heart failure (HF) is the primary cause of hospitalizations and readmissions to a hospital within 30 days of initial discharge. Optimizing outpatient care is vital to effectively manage this patient population. Objective: The purpose of this paper is to describe and evaluate the effectiveness of an optimized outpatient HF clinic. Patient outcomes from a Midwestern community hospital were based on quality of life (QOL) and readmission rates. Results: Enrolled patients demonstrated improvement in their QOL in the emotional, physical, and overall scores across the first 6 months of care. There were significantly fewer 30-day all-cause readmissions when compared to non-Clinic patients. Conclusion: Utilization of an APN-managed multidisciplinary HF clinic improved patient’s QOL and contributed to one hospital’s decreased all-cause readmission rates for the HF population

Objectives

Methods

Discussion

Conclusion