Heart Failure Clinic Is a Success
Since the Heart Failure Clinic at North Kansas City Hospital opened in the summer of 2013, patient volumes have increased each month. Target patients are those who, in addition to their HF disease process, are the most difficult to medically manage. They have a higher risk of returning to the hospital or ED shortly after discharge, unless they are seen by their primary care physician, cardiologist, or the HF clinic.
HF Clinic readmission rates are holding steady at 11% while Hospital Compare reports the national average is 23%. "The program has been very successful," says cardiologist David Hahn, MD, FACC. Patients of our HF Clinic have half the readmission rates of those not seen at the clinic. These numbers are impressive when you consider the high-risk population we work with.” Dr. Hahn is co-medical director of the HF Clinic with electrophysiologist L. Brick Rigden, MD, FACC, both with Meritas Health Cardiology.
The HF Clinic receives daily reports on patients who have been treated in the ED and they call each one within 24-48 hours of hospital discharge to ensure they received all of their medications. The clinic also sees these patients within 7-14 days, and they are scheduled for follow-up by a cardiologist as their symptoms dictate.
In collaboration with the patient, the HF Clinic focuses on dietary and medical compliance and initiates proven HF treatments based on AMA guidelines. The clinic also partners with North Kansas City Home Health to manage the home setting.
Patient education is an essential part of the comprehensive program:
- Disease management
- Low-sodium diet
- Fluid restrictions
- Nutrition counseling
- Symptom alerts
- Medical adherence assessment
- Daily weights
- Blood pressure
- Blood sugars
- RN 1:1 visits
- IV inotrope therapy
- Intermittent IV diuretics
- Blood and iron infusions
- Referral for devices
- Referral for transplant (evaluated by Mid-America Heart Surgeons, located on the NKCH campus)
- Social workers and case managers
- Home Health
- Wound management
"Our vision was not to simply treat the process but manage the whole patient," Dr. Hahn said. "I think there is nothing like it in the Northland or metro area. The clinic is a huge asset for this patient population as it improves their quality of life and maximizes their longevity." He gives credit to Ann Palmer RN, DNP, FNP-BC, CHFN. "She turned the HF Clinic concept into a reality."
With dropping readmission rates, the clinic proved beneficial almost immediately. Currently the clinic treats more than 50 patients a week and plans to expand to assist a wider patient population. Additional goals for the clinic are to secure accreditation, offer clinical trials and participate in the AMA database.
David Hahn, MD, FACC
Dr. Hahn earned his medical degree at Carver College of Medicine, completed his residency at Vanderbilt University Medical Center and a fellowship at Carver. His areas of interest include treatment of heart failure coronary, peripheral interventions and closure of patent foramen ovales.