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Winter 2015 - WakeMed Heart Failure Program Celebrates 15 Years

H2H Winter 2015 Heart Failure

Y2K meant more than the turn of the century for congestive heart failure (CHF) patients in Wake County and the surrounding area. It was the year many of them took control of their CHF with the help of the newly established WakeMed Heart Failure Program.

“It was happening nationally and internationally,” explains Marian Uy, RN, manager, WakeMed Congestive Heart Failure Program, when discussing the frequent hospital readmissions of patients with heart failure in the 1990s. “We would get their symptoms under control in the hospital and send them home, only for them to come back in two or three weeks with the same symptoms.”

“We kept asking ourselves, ‘What is the gap in care for these patients?’”, said Uy. After some formal and informal research, the WakeMed Heart Failure team had its answer: Education. CHF patients need ongoing education and support to manage their symptoms, stay out of the hospital and, most importantly, enjoy life despite their heart disease.

“That’s the goal of the program— to help people live longer and preserve quality of life,” says Dr. Brian Go, an interventional cardiologist with WakeMed Heart & Vascular Physicians and past medical director of the WakeMed Congestive Heart Failure Program. “A person with heart failure can live a full life and do very well if they know how to manage their symptoms.”

H2H Winter 2015 Heart Failure Dr. Go

With Betsy Gaskins-McClaine, RN, now the vice president of the WakeMed Heart Center, as the program’s leader, the team obtained a three-year grant to essentially prove the value of the program. Marian began her work with patients who were readmitted to the hospital with CHF symptoms by asking them a simple question: “May I speak with you?”

“We are straightforward with patients. We tell them that they have heart failure and it isn’t going away, but they can avoid getting really sick by learning how to make the right lifestyle changes and how to recognize when they need help before their symptoms get out of control and they have to be readmitted to the hospital.”

To be eligible for the program, patients:

  • Must have CHF as their primary diagnosis
  • Have been readmitted to the hospital because of CHF
  • Referred by a physician

“We practice under the advice of our physicians,” explains Wendy Anderson, RN, clinical educator/supervisor, WakeMed Congestive Heart Failure Program. “We follow physician prescriptions and protocols and we have strong working relationships with them, which helps our patients get the help they need in a timely fashion.”

Education begins at the bedside. It involves:

  • information about a low-salt diet
  • the importance of taking medications on time
  • fluid intake
  • weighing yourself at the same time every day
  • recognizing when to call their doctor or the congestive heart failure program staff if symptoms worsen

Once a patient returns home, that education continues via phone calls from program team members. “If a patient’s symptoms begin to worsen, we can reach out to the physician, who decides whether or not a prescription or dosage change needs to be made.”

The phone calls gradually cease, but patients always have a number to call – 919- 350-5732 – if they have a question or concern. “The sooner you call us, the faster we can get the help you need to feel better and potentially avoid a readmission to the hospital,” says Uy. And, program participants have access to a quarterly newsletter as well as support group meetings.

“Hospital readmissions for CHF have decreased, and that means our program is succeeding,” says Dr. Go. The WakeMed Congestive Heart Program has also been recognized and accredited by state and national organizations. The WakeMed program consistently receives American Heart Association Get With The Guidelines®-Heart Failure recognition for high-quality patient care. And the program was the first in North Carolina to earn accreditation by the Society of Cardiovascular Patient Care.

Congratulations to the WakeMed Congestive Heart Failure Program for 15 years of improving the quality of life for people with heart failure.