While healthcare reform efforts are driving hospitals to look for ways to reduce readmission rates, the Lourdes Cardiology Heart Failure Center has been working for over five years to address the leading cause of hospitalization for patients over age 65: congestive heart failure. The Center, which now follows close to 1,000 patients, has demonstrated a significant reduction in hospital readmissions from an average of 2.9 hospitalizations in the year prior to program enrollment to an average of 1.0 hospitalizations in the following one to three years after intervention, a greater than 50 percent reduction in hospitalizations. In addition, patients showed an 83% improvement in quality of life scores.[1]

"From the beginning, our focus has been to offer a patient-centered approach that fundamentally shifts treatment of congestive heart failure (CHF) from reactive to proactive and that emphasizes evidenced-based care," explained Robert Mohapatra, MD, MPH, FACC, Medical Director of the Lourdes Cardiology Heart Failure Center, the only dedicated provider for heart failure management in Southern New Jersey.

The Lourdes Cardiology Heart Failure Program uses education, surveillance and strict compliance to nationally established guidelines for the treatment and management of CHF. Highly trained nurse practitioners and RNs work closely with patients to improve survival, quality of life, avoid hospitalizations and reduce overall costs.

Improving Health, Reducing Cost

CHF affects nearly five million people in the U.S. with over 500,000 patients newly diagnosed each year. More than half of those who develop CHF die within five years of diagnosis. Due to the complexities surrounding the disease, medical supervision and continuous monitoring of the patient is crucial but often difficult to achieve. The American Heart Association reported that the average hospital readmission rate for CHF is 50 percent at six months.

As baby boomers age, there is a concern that the healthcare utilization and costs for CHF will rise exponentially, unless providers can develop and maintain chronic disease management programs that can reduce cost and improve care. Left unchecked, CHF diagnoses, and their associated costs, are predicted to double by the year 2037.

"With 60 percent of CHF costs related to hospitalizations each year, it is essential that major heart centers like Lourdes develop proven therapies and processes to combat this very insidious condition that severely impacts quality of life of both the patients afflicted with this disease as well as the families members that have to help care for them," noted Reginald Blaber, MD, FACC, Executive Director and Vice President of Cardiovascular Services at Our Lady of Lourdes Medical Center.

Lourdes was recently recognized as number one in the state of New Jersey and among the 100 Best Hospitals in America for Cardiac Care by HealthGrades, the nation's leading healthcare quality ratings organization. The hospital was also cited as a 5-star center for heart failure for demonstrating better than expected outcomes. No other health system in South Jersey can boast of such a program, much less the results.

A Team Approach--Including the Patient

"The Lourdes Cardiology Heart Failure Center works to empower patients and their families to be active members of their healthcare team," explained Tamarah Moffatt, MSN, APN-C, BC-ADM, an advanced nurse practitioner who specializes in heart failure management.

Multiple studies have shown that the effective treatment of CHF requires a strict dedication to monitoring one's health details: daily weights, taking medications and changes like fluid retention and fatigue immediately so that the team can appropriately intervene via phone or office follow up, which may involve intravenous diuretics.

"By keeping in close contact with the patients by phone or office visit, we can better manage care. Patients can tell right away that their quality of life improves by following these protocols. They avoid hospitalization--which disrupts their lives and the lives of their family--and can get back to their life," added nurse practitioner Joanne Luczak-Marzo, MSN, APN-C., director of the Outpatient Heart Failure service.

In order to obtain these results, the staff is committed to an aggressive and repetitive process of educating the patient and their family about the disease process, its symptoms and interventions that they can take themselves at home. This empowers patients to participate in the care of an illness that they previously felt powerless to combat.

"Over the past five years, Lourdes Heart Failure Center has continuously improved its processes and approaches to deliver patients the highest standard of cardiac care in the region. The truth is in the numbers--if you look at our post-treatment readmission rates, there are no readmissions for at least 31 days and less than one-fifth of those who are readmitted are for heart failure reasons. This is a testament to the expert team we have and the personalized, individual care that we provide to our patients. They truly are at the heart of everything we do," explains Dr. Mohapatra.

About the Lourdes Cardiology Heart Failure Center

A critical component to combating heart failure is first by understanding it. Lourdes Cardiology Heart Failure Center is a proven education and treatment program designed to help patients control their disease by understanding their condition and teaching them how to manage their health. The Center's outpatient setting provides convenient and easy access to cardiology services to minimize the need for hospital readmission. The Center was established five years ago by Associated Cardiovascular Consultants, one of the largest cardiology practices in New Jersey, which was acquired by Lourdes Health System last year. The Center's outpatient team works closely with local hospitals to create a seamless continuum of care for the patient so, if they should need to be hospitalized, they have good education and support to make the transition back home.

When a patient is referred to the Heart Failure Center, the patient becomes an active participant in their treatment plan. Through the program, the team of Heart Failure experts:

• teach patients how to change and maintain lifestyle behaviors that can greatly affect their condition;
• provide optimal personalized treatment with medications and advanced therapies that improve symptoms and increase levels of activity improve quality of life;
• carefully observe and regularly track the progress of each patient, allowing for a change of medication or introduction of potentially more effective therapies or support as they become appropriate;
• participate in research protocols which may further improve and advance the care that patients receive.

Patients enjoy the team creed that the Center operates by and believe this to be a major contributing factor to their success. By making the patient and their primary care physician the key players on the team, all parties have a greater understanding of the disease and ultimately have a better handle on the patient's care.

The Heart Failure Center changes the paradigm by taking a proactive approach to treating heart failure patients. With the main goal to maintain or improve the quality of life of participants with heart failure and to prevent emergency department visits and hospital admissions whenever possible, the Heart Failure Center provides patients with continued follow up care for as long as it is needed.

About Congestive Heart Failure (CHF)

With CHF, the heart muscle weakens and it works harder to keep blood flowing through the body. As the weakened heart muscle struggles to deliver enough oxygenated blood to the body, the muscle becomes bigger and eventually changes its shape leading to cardiac dysfunction and symptoms of heart failure. Congestive heart failure (CHF) affects nearly five million people in the U.S. with over 500,000 new patients diagnosed each year. More than half of those who develop CHF die within five years of diagnoses. Due to the complexities surrounding the disease, medical supervision and continuous monitoring of the patient is crucial.

Heart failure is a common condition that usually develops slowly over time. As the heart muscle weakens, it works harder to keep blood flowing through the body. As the weakened heart muscle works harder to deliver enough oxygenated blood to the body, the muscle becomes bigger and eventually changes its shape leading to cardiac dysfunction and symptoms of heart failure.

In most situations, heart failure is caused by another existing health problem or disease such as coronary artery disease or high blood pressure. These health problems may contribute to more advanced heart failure if not adequately treated or managed. Men are more likely to experience heart failure and the risks of developing the disease increase with age.

The economic impact of heart failure is devastating. Thirty-eight billion dollars is spent annually to treat patients with heart failure with sixty percent of costs related to hospitalizations. Heart failure equates to nearly 6.5 million hospital days each year.