Home Care Visits Lessen Need to Be Hospitalized Again

The results of a recent study conducted at North Shore University Hospital clearly indicate that patients who receive follow-up home care from a nurse practitioner following cardiac surgery were less likely to need readmission to the hospital within 30 days of their initial stay, and also achieve a higher survival rate than patients who do not.  In fact, patients who had no assistance at home after their surgery were re-hospitalized at triple the rate (almost 12 percent) of those who do have in-home assistance (almost four percent).

The Advantages of In-Home Care

According to Dr. Michael Hall, who is NSUH's Chief of Adult Cardiac Surgery, the nurse practitioners who cared for the patients in their homes had also cared for them during their hospital stays and so were familiar with their conditions and their particular needs.  The NPs visited their patients at home for the first two weeks following discharge twice weekly.  During these visits, the Nurse Practitioner's job was to:

• Provide the patient with a physical exam
• Provide management of the patient's medication
• Serve as a liaison for the patient with his/her family doctor, cardiologist, pharmacist, others
• Contact social service agencies for future needs, if necessary

The NPs participating in the studies had special smart phones that were encrypted for patient information privacy to allow them to send the surgeons patient data, vital signs and photographs of patients' surgical sites for care instructions. The patients continued to receive the latest in updated care for these weeks following their surgery even though no longer being supervised in a hospital setting but enjoying the comfort of home.

Additional Findings of NSUH Continued Care at Home Study

As summarized by the May 2014 article on this study in The Annals of Thoracic Surgery, Dr. Hall also spoke of some of the problems the NPs dealt with while working with the patients in the study that are indicative of the reasons patients without care at home fare poorly and must return to the hospital for further care. These are:

• Failure to fill new prescriptions due to cost issues
• Substituting their old prescriptions instead to save money because they erroneously believe they are still good or appropriate, when they are not
• Not following up with seeing doctors in the community for lack of transportation

Nurse practitioners were able to help patients with these and various other issues on an individual basis because they could respond within that patient's community to his or her needs once they visited them in their home.