Helping heart patients recover at home

Sharp Grossmont Hospital opened its Heart Failure Clinic in 2020. Located within the Burr Heart & Lung Clinic, the clinic is designed as a bridge to follow-up care from a patient’s cardiologist or primary care doctor after the patient leaves the hospital.

The Heart Failure Clinic staff offers services such as ensuring medications are up to date, performing physical exams and discussing advanced illness management. Staff members work with patients to make sure that they understand and follow the care plan given to them when they go home from the hospital. Patients are usually seen three to seven days after they leave the hospital.

Preventing another cardiac event after heart failure
“Heart failure is a lifelong condition,” says Kelsi Ostenson, director of Ambulatory Services at Sharp Grossmont Hospital. “The mission of the Sharp Grossmont Heart Failure Clinic is to provide exceptional care to patients who have been treated and discharged from our hospital for heart failure, but are at high risk for having another cardiac event that may bring them back to the hospital.”

It may take several weeks before some high-risk patients have a follow-up appointment with their cardiologist or primary care doctor. Being able to identify these patients and arrange for them to visit the clinic shortly after leaving the hospital is a way to help reduce the risk of another cardiac event, and allows patients to live their lives as symptom-free as possible.

Betty’s story
One patient who has benefited from the Heart Failure Clinic is Betty Fischer. At 89 years old, Betty has had a long history of cardiovascular disease. In her mid-60s she retired from her career as a college department administrator due to complications from atrial fibrillation (AFib), a type of abnormal heart rhythm. As years passed, Betty survived three heart attacks, the first in 2012, the second in 2015 and the third in 2020. She also had several procedures to place stents in her major blood vessels.

“When I had my third heart attack this year, I was having chest pressure,” recalls Betty. “My daughter took me to the emergency department.”

Betty soon learned that she had developed congestive heart failure, a chronic condition that occurs when the heart is unable to pump blood efficiently to the rest of the body. Congestive heart failure is often caused by high blood pressure or coronary artery disease (narrowed blood vessels) that, over time, can weaken the heart.

Newly diagnosed, Betty’s care team started her on medications specifically for congestive heart failure, as well as made changes to some of her other medications. Shortly after being sent home from the hospital, she had a follow-up visit at the Heart Failure Clinic.

“Patients over age 65 are potentially at a higher risk of developing side effects from medications that might not be evident until after they are discharged,” says Leslie Hazard, cardiology nurse practitioner at Sharp Grossmont Hospital. “Patients are oftentimes overwhelmed when diagnosed with a new condition, such as congestive heart failure. It takes time to process and understand their new disease. At the clinic, we can work with them one-on-one to assess their vital signs, go over their adherence and tolerance to medications, as well as discuss any questions or concerns they may have.”

Helping families help the patient
Hazard notes that, surprisingly, the Heart Failure Clinic has also served as a vital resource during the COVID-19 pandemic.

“Since the start of the pandemic, because of new hospital visitor policies, family members are unable to be at the patient’s bedside to receive medication and discharge instruction teaching from the nurse before the patient leaves the hospital,” explains Hazard. “The clinic is an ideal environment to teach a patient’s family how to care for and monitor their loved one at home. At the clinic, our clinicians can spend time with the family and patient to review everything that was discussed during the hospitalization.”

Betty still has symptoms, such as shortness of breath, and she now uses a cane to walk. But as she learns to manage her symptoms and new condition with the help of her family and doctors, she is grateful for the continuum of care she has received so far.

“From Colleen Austel Nadeau, who was my heart failure nurse who cared for me while in the hospital, to my doctors and the entire team that sees me now, they are all absolutely fabulous. They have all been extremely wonderful.”