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Heart Institute program aims to reduce readmission rates

Jan. 30, 2014, 9:45 AM

From left, Keith Churchwell, M.D., executive director and chief medical officer of Vanderbilt Heart and Vascular Institute, Brittany Cunningham, MSN, R.N., senior quality and patient advisor, and Mark Glazer, M.D., accept a plaque from Shilpa Patel and Nicole Wilson of the American College of Cardiology, which has selected Vanderbilt Heart to be one of the pilot sites for the Patient Navigator Program. (photo by Roseanne Johnson)

Vanderbilt Heart and Vascular Institute is one of 11 centers selected by the American College of Cardiology (ACC) to implement a new program designed to reduce readmission rates for patients with myocardial infarction, heart failure and acute coronary syndrome.

The Patient Navigator Program was rolled out at the Vanderbilt Heart Town Hall on Jan. 24.

Sponsored by the ACC and AstraZeneca, the program offers a personalized approach focused on meeting the needs of heart disease patients before and after they leave the hospital.

“We have had a multidisciplinary task force working on readmissions for the past year and a half,” said Brittany Cunningham, MSN, R.N., senior quality and patient advisor. “The success of our model has been driven by the clinic nurses and staff with whom the patients already have relationships. This was a team effort accomplished by all of VHVI.”

Key interventions behind the reduced rates include improved education to the patient, follow up phone calls and completed clinic visits within 7-10 days. As a result, acute myocardial infarction readmissions have gone from 23.3 percent in 2012 to 19.3 percent in 2013. Heart failure readmissions have gone from 24.1 percent in 2012 to 21.3 percent in 2013, according to

“The ACC saw our success to date and wanted to help us build on our foundation. Being a part of the Patient Navigator Program will allow us the opportunity to focus more efforts on acute myocardial infarction and heart failure readmissions and broaden our efforts beyond what we have learned so far,” Cunningham said.

Nationally, nearly 1 in 5 patients hospitalized with heart attack and 1 in 4 patients hospitalized with heart failure are readmitted within 30 days of discharge, often for conditions seemingly unrelated to the original diagnosis, according to the ACC.

Readmissions can be related to issues like stresses within the hospital, fragility on discharge, lack of understanding of discharge instructions and inability to carry out discharge instructions.

“We believe that the more contact we have with our patients after discharge the more likely they won’t need readmission. Funding for the Patient Navigator Program will be used to further our efforts to improve the way we take care of patients at Vanderbilt,” said Mark Glazer, M.D., assistant professor of Medicine.

The ACC created the Patient Navigator Program to support caregivers at the 11 hospitals as they help patients overcome challenges during their hospital stay and in the weeks following discharge when they are at most risk for readmission. Hospitals have been given funding to establish a program that supports a culture of patient-centered care that can potentially be implemented in other hospitals in the future.

“The ACC Patient Navigator Program will serve as a test for innovative, patient-centered solutions to address issues that impact patient health and patient readmissions,” said ACC President John Harold, M.D. “These hospitals will serve as pioneers in a new approach to heart disease treatment and care that puts emphasis on meeting patients’ ongoing needs and helping patients make a seamless transition from the hospital to the home.”

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