2019 Best Practice Awards Submission for Reduction in Utilization
The Advanced Heart Failure Clinic identified a need for additional patient support and a lack of care coordination between the PCP, hospital, and specialty. The decision was made to embed a full time RN Care Manager into the Advanced Heart Failure Clinic. In the first year, the RN CM conducted 1,826 visits with patients. He provided care coordination and supported the Heart Failure Clinic interventions with these patients. Analyzing a cohort of 25 patients, results of this work demonstrate a 43% reduction in ED utilization and a 48% reduction in Inpatient Admissions.