Patients with heart failure enrolled in the Christiana Care Visiting Nurse Association telemonitoring program are much less likely to be rehospitalized than the national average, according to statistics by Strategic Healthcare Programs (SHP).
In the telemonitoring program, nurses from the VNA work closely with patients to electronically monitor such vital signs as weight, blood pressure and the oxygen levels in the blood so patients can make adjustments as soon as their numbers indicate a problem. Nurses also help patients to set goals and maintain heart-healthy diets.
In New Castle County, 22.8 percent of heart-failure patients were readmitted to the hospital within 30 days of discharge. That is significantly lower than the 32.7 percent of patients readmitted nationwide, says SHP, a developer of monitoring technology.
“The program provides much more than technology,” says Gale Bucher, RN, MSN, director of Quality & Risk Management, Christiana Care VNA. “Nurses educate patients and coach them so they understand their treatment plans.”
Nurses work with patients to establish personal goals, such as being able to walk to a neighborhood coffee shop to meet friends.
Christiana Care VNA rolled out telemonitoring in 2005. The telemonitor is a device that patients use in their homes to transmit their vital signs and other information to a health care provider. In addition, the telemonitor asks patients “yes/no” questions about their symptoms. A nurse at the central monitoring station evaluates the information and may call the patient to talk about any symptoms, diet or medications. The nurse also can use the data for clinical decisions, including contacting the doctor to discuss a change in the plan of care.
Adding equipment that does not require a telephone land line has enabled VNA to reach more heart-failure patients who can benefit from telemonitoring. “But it isn’t just the equipment,” Bucher says. “How the equipment is used, and placing the equipment with the right patients plays a big part in our success.”
VNA reduces hospitalizations and falls
Christiana Care Visiting Nurse Association is also reducing the number of hospitalizations and falls of home health care patients. Last year the VNA achieved a 18.8 percent hospitalization rate for Medicare patients, compared to a national rate of 25 percent. Also, patients requiring emergency care because of falls dropped to 0.8 percent, a 10 percent improvement from 2010 and better than the national rate of 1.4 percent. That translates into saving approximately 50 VNA patients from serious injury because of falls.