Hospital Readmissions Reduced Significantly Using Novel Heart Failure Protocol

Doctors at The Allure Group developed new remote monitoring procedures that improve patient outcomes and keep costs down

A novel protocol that remotely monitors congestive heart failure patients in skilled nursing facilities and uses automated alerts to notify cardiologists of significant changes in the patients’ health has dramatically reduced hospital readmissions while improving patient outcomes and keeping costs down.

The new “Hearts in Motion” protocol, developed for The Allure Group by its Chief Medical Officer Rekha Bhandari, MD; Jeffrey Bander, MD; and Chief Operating Officer Melissa Powell, was shown to reduce hospital readmissions from skilled nursing home facilities from 31 percent to seven percent over a seven-month period, involving 152 patients. This was accomplished without increasing the cardiologist’s presence onsite or associated costs.

The protocol employs a remote system that uses real-time data to direct attending cardiologists to the patients in need of the most critical care. Upon admission to the nursing facility, a multidisciplinary team including a cardiologist, nurse and a rehab social worker were assigned to patients with a history of cardiac disease. The staff was educated regarding signs and symptoms of congestive heart failure, and strict protocols for measuring weights, renal function and brain natriuretic peptide (BNP) were established. 

Monthly onsite team meetings and weekly webinars were conducted to review each patient’s progress. Automated alerts were also setup to notify the cardiologist of significant patient weight changes or significant change BNP and renal function. The physician then directed treatment based on these values and clinical information. 

Dr. Bhandari, who serves as Allure’s Chief Medical Officer, says: “Research shows that approximately one-in-five Medicare recipients who are hospitalized for congestive heart failure are discharged to a skilled nursing facility for continued care. Almost 25 percent of these patients are readmitted to acute hospitals within 30 days. The heart failure protocol we developed and implement gives our patients top quality medical care compassionately and efficiently. The protocol will have significant and positive impacts on long-term care. We are very proud of our accomplishments.”  

According to Bhandari, “Improving patient outcomes – reducing the number of readmissions for heart failure – is the primary benefit of the new protocol. But not to be lost in this equation is how the protocol improves time and cost efficiency for doctors and staff. When the procedures are followed and closely monitored, we have been able to appropriate our resources more effectively and maximize care for patients who need it most throughout our care network. The implications for this moving forward are clearly positive.”

“The practical impact of this program for our patients is that it brings the focus and detail of acute care to the subacute level,” adds Powell. “That means our treatment and caregiving can be more effective in keeping patients out of the hospital.”

The Hearts in Motion protocol study was administered at five skilled nursing facilities in New York City operated by The Allure Group. Drs. Bhandari and Bander presented the study at the Heart Failure Society of America (HFSA) Annual Scientific Meeting in 2015.

Founded on the principles of compassion, respect and clinical excellence, The Allure Group is a network of comprehensive skilled nursing facilities in New York City that offer innovative rehabilitation programs and sub-acute nursing care. Facilities include Hamilton Park Center in Bay Ridge, Linden Center in East Flatbush, Bedford Center in Williamsburg, King David Center in Bensonhurst, Crown Heights Center, and Harlem Center.

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