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Heart Failure Clinic, Observation Unit opened in 2018

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Heart Failure Clinic, Observation Unit opened in 2018

Heather Byars (left), office assistant, and Emily Costolnick, RN, clinical manager of the Heart Failure Clinic. / Floyd Medical Center

In 2018, Floyd Medical Center added two new services to help improve the already strong health care it provides to the community. These services included an Observation Unit inside the hospital and a Heart Failure Clinic to monitor patients with heart failure once they have been discharged from the hospital.

The 11-bed Observation Unit on the fifth floor of the hospital is a dedicated short-stay unit where health care providers can place a patient in an active, short-term setting to determine if the person needs to stay longer the hospital or can safely go home. Observation patients typically stay 1 to 2 days with the goal for most patients being 24 hours or less.

While in the unit, a patient receives monitoring, laboratory work and diagnostic testing to help providers determine the best plan of care for a patient.

Keri Bush is Clinical Manager of the Observation Unit. She says that there are many types of problems that support the need for a short period of observation. “We see patients with symptoms that usually can resolve in 24 to 48 hours or that are in a situation where there isn’t a clear directive to admit to an inpatient bed,” said Bush.

“Common problems seen in our unit include nausea and vomiting, stomach pain, shortness of breath, dehydration, chest pain and high blood pressure. The intent is to allow providers additional time past the Emergency Care Center evaluation to decide whether to discharge home or admit a patient,” said Bush.

While patients are on the unit, vital signs, such as pulse, blood pressure, temperature and respiration rate, are taken every four hours. Laboratory blood work is drawn periodically, and every morning a nurse and the nurse practitioner will round together and discuss the plan of care and test results, and answer any questions.

“We found that the majority of patients truly appreciated an environment that was focused on getting them out the door if they were safe to go home,” said Bush.

The Observation Unit cared for over 2,100 patients in 2018.

The Heart Failure Clinic opened in June 2018. Located in the 330 Physicians Center next to Floyd Medical Center, the goal of the clinic is to help patients manage their heart failure on an outpatient basis rather than having to be admitted to the hospital.

Heart failure is when the heart is not strong enough to circulate blood throughout the body or to adequately pump out the blood that has been returned to the heart. Although there is no cure for heart failure, its symptoms can be managed.

The most common symptoms of heart failure include problems breathing; swelling in the legs, ankles, feet, and stomach area; and unusual tiredness.

Heart failure is one of the most common reasons people age 65 and older go into the hospital.

“We provide patients with education and resources, so they can learn how to manage the symptoms, rather than allowing the symptoms to manage them,” said Emily Costolnick, clinical manager of the Heart Failure Clinic. “Our main goal is to keep patients out of the hospital. We want to keep patients at home in their own bed,” said Costolnick.

“We help patients understand the importance of daily weight checks. Weight gain can be one of the first signs of fluid buildup, which can lead to other problems. We also educate them on sodium and fluid restrictions and give suggestions for whatever they are struggling with,” said Costolnick. In addition, the clinic provides lab work and medication management.

Patients are seen by Dr. Himanshu Patel, a cardiologist with Harbin Clinic who serves as medical director, and Marenda Russell, a nurse practitioner with Harbin. These providers develop individualized treatment plans for each patient.

Statistics show that patients who can manage and treat their heart failure at home with the help of clinic staff have fewer hospital stays.

“Since the Heart Failure Clinic opened, we have seen 180 patients, and this number continues to grow daily. There has been a steady downward trend in heart failure readmissions to the hospital since July 2018. In November and December 2018, those readmission rates were below 5 percent,” Costolnick said.

“We’ve had patients who, when they were first seen at the clinic, were in a wheelchair and on oxygen, and it’s all they can do to get to the clinic. Now they are walking down here, and they are not on oxygen. They are actually able to do stuff. We have patients who were in the hospital at least once a month or more often, and now they haven’t been in the hospital in a couple of months, and they are going to the gym and doing physical activity almost daily,” said Costolnick.

Patients must be referred to the Heart Failure Clinic either by providers during a hospital stay, or by their primary cardiologist or primary care provider.

The clinic is located in Suite 103 on the first floor of the 330 Physicians Center and is open Monday through Friday.

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