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28 May 2024, by Amy Sarcevic
A new nurse practitioner service for patients with heart failure is driving down hospital readmission and mortality rates, saving hospitals up $110,000 every year.
The initiative was devised by Professor Andrea Driscoll of Deakin University and Monash Health when she noticed education and support for this patient group was lacking.
“On busy wards, people with heart failure are often sent home without any specialist referrals or knowledge on how to self-manage their condition. As a result, they tend to come back in weeks later with fluid build-up and preventable complications,” she said.
The issue appears to be widespread, despite heart failure having some of the worst mortality and readmission rates of any health condition.
Around one quarter of people with heart failure will re-present at hospital within one month of discharge, and around half will not survive beyond five years of their diagnosis.
Prof Driscoll felt confident that an inpatient program could improve these statistics, but even she was surprised to discover the actual impact.
“For example, I knew that informing patients about the warning signs of deterioration could help them manage fluid build-up in the heart before it caused any further damage. But I was amazed by how much difference this – and other aspects of the program – made. It has reduced rehospitalisation by 17 percent and, financially, saved our hospital almost $300,000 in three years,” she said.
Education is delivered to patients during a pre-discharge consult with a dedicated heart failure nurse practitioner, who also checks their medication and gives appropriate referrals.
“This works well because hospital patients are a captive audience,” Prof Driscoll said. “They are also feeling pretty unwell at the time they speak to the nurse practitioner – so in terms of education, it’s a really good incentive to start healthy behaviours. Of course, many will forget what they are told, but that’s not a good enough reason to skip inpatient education.”
Prof Driscoll believes the approach will also see good outcomes for other types of chronic disease including COPD, asthma, and hypertension.
“Anything that benefits from daily practical education – like teaching someone with abnormal heart rhythm to avoid coffee and chocolate. It might seem obvious, but people only know what they are told. And on busy wards, patient education is a fairly low priority compared with medication and more immediate medical attention – so it pays to have a dedicated service aimed at providing this.”
Driscoll’s model has already been trialled in a number of Australian hospitals and achieved similarly impressive results. But how will the approach fare in private health?
Join Prof Driscoll for further discussion on this topic at the upcoming Health Insurance Summit, hosted by Informa Connect.
This year’s event will be held 24-25 June at the Grand Hyatt Melbourne.
About Prof Driscoll
Professor Andrea Driscoll is Chair of Nursing at the Centre for Quality and Patient Safety Research – part of Monash Health Partnership. She is an internationally renowned, award-winning researcher, focussed on advanced practice nurses, nurse practitioners and system redesign.
Her work provided a solid evidence base on which to improve practice and reduce disparities in healthcare. She previously worked with Safer Care Victoria leading their statewide program of work in heart failure driving consistent system-wide improvements in service delivery and health policy across the State.
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