Aspirus Langlade Hospital is implementing a new patient care plan to decrease the number of admissions and readmissions to our hospital of patients with congestive heart failure.
Congestive heart failure is one of the most common reasons for admissions to the hospital and a leading cause of healthcare costs in our country. Current estimates are that there are approximately 5 million people in the United States with a diagnosis of congestive heart failure and every year almost 500,000 people are diagnosed with this condition. Each admission to the hospital costs approximately $11,000, but more importantly if that same patient were to be readmitted to the hospital within a few days of being discharged from the hospital that cost will go up to approximately $13,000 per readmission. These readmissions cost Medicare 17.4 billion dollars a year. Reducing this readmission not only leads to significant cost savings, but also improves quality of care.
There are several reasons for this early readmission within 30 days for recurrence of heart failure including patients not following instructions, not taking medications or restricting fluids, poor communication during the hospitalization or patients not understanding discharge instructions, inability to pick up their medications, lack of transportation and lack of early follow-up with their primary care doctor. It is estimated that up to 75% of these early readmissions can be prevented.
Aspirus Langlade Hospital decided to take an initiative to reduce the number of patients being admitted and readmitted to our hospital with congestive heart failure. They established a multi-disciplinary team including a physician, nurses, pharmacists and specialists from social services, quality management and home care to create a comprehensive discharge plan which provides for both short-term and a long-term plan of care for patients hospitalized with a diagnosis of congestive heart failure.
If you or your loved ones are admitted to Aspirus Langlade Hospital with a diagnosis of heart failure, you will expect to:
• Meet with case management specialist who will assess your medical and social situation and will then work with the rest of your healthcare team to address any potential risks that might contribute to you being readmitted with the same diagnosis.
• You will receive a folder containing some educational material and will also have a book with instructions on monitoring your daily weight, exercise and your daily intake of fluids and salt. You will be advised to bring this folder and the book with you to your appointments with your physician.
• If you do not have a scale to weigh yourself at home, you will be provided with one when you leave the hospital.
• You will be provided discharge instructions by members of your healthcare team and they will be willing to answer any questions that you or your caregiver might have about follow-up care and will make an appointment with your own personal physician within 3-5 days of leaving the hospital.
• You will be contacted by a nurse within 3 days of going home to check on you and to answer any questions or concerns that you or your family might have about your health or the recent discharge from the hospital.
When you meet with your doctor, after leaving the hospital, he or she might also advise you to see the Patient Centered Medical Home Coordinator-a nurse who will work closely with your doctor and the rest of your healthcare team to manage your heart failure effectively at home.
The staff and administration of Aspirus Langlade Hospital are hoping that this multi-disciplinary approach to taking care of patients with congestive heart failure during the hospitalization and in the immediate post discharge will help the patient and their family members take care of their health, help reduce the costs and the morbidity and mortality of admissions and readmissions with congestive heart failure.