Hospital Starts Heart Failure Program | Video

Michelle San Miguel | 9/28/2012

We reported yesterday on a new penalty that kicks in next week to encourage hospitals to cut back on high readmission rates. Sanford Medical Center in Bismarck will lose Medicare reimbursement funds for its frequent readmission of heart failure patients. But the hospital is working to cut back on those repeat patients.

Medicare looked at readmissions from 2008 to 2011 when deciding which hospitals would be penalized. This year Sanford began a heart failure program to lower those numbers and hospital officials say it`s working.

Heart failure is a chronic disease that can worsen when patients have a poor diet rich in salt.

"Salt retains fluids and fluids get your heart in trouble because that fluid just backs up into your other systems," said Vice President of Clinical Quality Evy Olson.

Olson says the hospital is working to make sure patients know which foods they should be eating when they go home.

"A lot of times what happens is that these patients are sick, they`re in the hospital, they go home, they don`t get a chance to see a doctor for a week or two and by that time some of them have regressed," said Heart Failure Program Director Dr. Walter Frank.

Three days after heart failure patients are discharged, Dr. Frank and his staff meet with patients in the clinic for a two hour visit. Providers go over medications and have patients undergo a physical and psychological test.

Patients who are readmitted are also meeting with a case management team, which includes a nurse, a social worker, and the patient`s family. The hospital says this sort of bedside rounding builds a support system for the patient.

"It`s having the patient and their family member or their caregiver in the room with everybody at one time and saying okay, what are your risks for going home? Do you have medications at home? Do you they understand the diet? What kind of food have they got in their cupboard?" Olson said.

Olson says the heart failure program is working. In the first six months of this year, 15 heart failure patients have been readmitted, compared to the hospital`s 42 readmissions between 2009 and 2010.

"The bedside rounding that we`re doing with the patient and the family and this whole care team right at the bedside, I don`t think we did that very well before the penalties came into play," Olson said.

Olson says some patients who were needing to be readmitted at Sanford aren`t as common anymore.

In many cases, nurses will also make visits to a patient`s home to help patents manage the patient`s heart failure.

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