ISSUE 148: Special Section

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Heart Centers Help Patients Heal

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LEXINGTON The health care system has become increasingly more complex and unfortunately the patient is left trying to find their way through the labyrinth of physicians, tests, procedures and hospitals. At Central Baptist Hospital, two centers, The Center for Atrial Fibrillation and Heart Rhythm Disorders and the Heart and Valve Center, have been designed to make the patient’s life easier and ultimately improve coordination of care between providers, patients and families.

Affecting millions of people in the U.S. alone, atrial fibrillation (A Fib) is a disorder of growing concern within the medical community. A Fib is not a benign disease. It doubles the risk of death in both men and women, with much of this excess mortality attributable to a significant risk of stroke. Treatment of atrial fib is not the most straightforward proposition with several treatment options available, each involving some form of medical management with antiarrhythmic or anticoagulation drug therapy.

The A Fib Center serves as a comprehensive source for the management of atrial fibrillation and other abnormal heart rhythms by providing state of the art options in the diagnosis and therapy of these disorders. As a center for research and clinical practice, the newest medications, the most sophisticated devices as well as the latest in minimally invasive procedures are available. Unique to the center is the A Fib coordinator, Lynn Mattingly, RN, who educates the patient and advises them on treatment options, arranges any necessary testing. Initial appointments typically last at least an hour allowing for ample time for in-depth education, and to assuage the patient’s fears. Mattingly reports that at least one patient told her they “had a real opportunity to discuss my concerns and questions about my condition.”

After every appointment, Mattingly communicates to the patient’s primary cardiologist and or primary care physician on the plan of care. She often facilitates getting a patient in to see one of the electrophysiologists sooner when their condition warrants. The care coordination the center is able to provide is critical when multiple providers are involved and to avoid wasteful duplication of diagnostic testing, perilous polypharmacy and confusion about conflicting care plans.

While coronary artery bypass grafting (CABG) volumes have decreased over the last 5 years due to drug-eluting stents, valve procedures have increased significantly. What used to be considered “traditional” surgery can now be done with minimally invasive, robotic and percutaneous techniques. The rising acuity of cardiac surgical patients has played a significant and challenging role. Indicative of this phenomenon is the surging incidence of the many comorbidities among CABG patients in recent years, including diabetes, renal insufficiency, cerebrovascular and lung disease. In the fall of 2011, the Heart and Valve Center at Central Baptist was opened as one strategy to deal with the complexity of care delivery. Utilization of a nurse navigator role has been key tenet of care in the center.

Liza Crall, MSN, APRN, cardiothoracic nurse navigator, is a nurse practitioner who follows all cardiac surgery patients through the entire experience from the point of entry through follow-up care and continued care. She consults with the patient and helps to explain the different surgical techniques and what the surgeon has decided will be the most beneficial to the patient. The nurse navigator role coordinates care throughout the treatment process by rounding daily to facilitate care, providing information to the patient and family, facilitating decision-making. “This was an enjoyable experience!” said a patient and his wife who recently visited the center for their cardiac surgery pre-admission care visit. By supporting and guiding the patient, she eases the stress and helps with questions and education after diagnosis and throughout treatment. “It is very fulfilling to know we can make such an impact on a patients and their family’s life,” says Crall.

At Central Baptist Hospital of Lexington, new heart care centers have emerged to improve coordination of care between providers, patients, and families.

Megan Switzer, MSN, APRN, FNP-BC, CCPC, works with Central Baptist’s Cardiac Network development. You can reach the A Fib Clinic by calling (859) 260-AFIB [2342]; reach the Heart and Valve Center by calling (859) 260-CABG [2224].