It’s 10 a.m. in the Levittown home of
Charlie Dispenzieri. A small medical
monitoring device sounds, greeting
Mr. Dispenzieri and reminding him
that it’s time to take his vitals.
(Pictured left)
Patricia Carman,
RN, Heart Failure
Nurse Coordinator
at Winthrop’s
Certified Home
Health Agency
(CHHA), assists
Mr. Dispenzieri with taking his vital signs and transmitting them to
CHHA Telemonitoring Coordinator Lorraine Greene, RN, (pictured
above), for thorough clinical review and evaluation. If the data
triggers an alert, Ms. Greene immediately follows up with the
patient to inquire about their symptoms.
Every day, the 87-year-old steps
on a scale and measures his blood
pressure and oxygen with simple
devices that attach to the monitoring
system, and answers a series of brief
questions about how he’s feeling. With
the simple touch of a button, he transmits
the information through his
telephone land-line to a computerized
monitoring system for clinical review
and evaluation by a nurse in Winthrop-
University Hospital’s Certified Home
Health Agency (CHHA).
Mr. Dispenzieri suffers from congestive
heart failure and for almost
two years, he has been a participant
in the Agency’s home telemonitoring
program – a remote monitoring program
that enables patients to take an
active role in their care under the
daily supervision of a skilled team of
clinicians. This specialized program
was designed to help patients follow
their post-hospital treatment plans
through personalized, physician-prescribed
therapies, education and
support provided at home.
“Telemonitoring has greatly
reduced the readmission rate of our
patients,” said Anne Calvo, RN, BSN,
MPS, Administrator, Winthrop’s
Certified Home Health Agency.
Before beginning the telemonitoring
program in 2008, frequent hospital
admissions were a regular occurrence
for Mr. Dispenzieri. But that all changed
after Patricia Carman, RN, Heart
Failure Nurse Coordinator at Winthrop’s
CHHA, conducted a comprehensive
assessment of his condition and created
a detailed plan of care in consultation
with his primary care physician Jack
Geffken, DO, of Bethpage Primary
Medical Care. Ms. Carman and Dr.
Geffken agreed – Mr. Dispenzieri was an
ideal candidate for telemonitoring services.
Since then, Mr. Dispenzieri has
had great success with the program,
for which he and his wife, Grace are
grateful.
“My husband
hasn’t been admitted
to the hospital
in over a year and
a half!” said Mrs.
Dispenzieri.
Education
Preventing incidents
and conditions
that can lead to
rehospitilization is
one of the Agency’s
goals. To that effect,
the staff educates
patients about self
care, disease prevention,
nutrition
and medication management in order
to slow disease progression and avoid
unnecessary hospitalization.
“By providing patients with consistent
care and educational tools that are
current and based on best practices,
we teach them how to better manage
their conditions so they can stay out of
the hospital,” said Ms. Calvo.
For heart failure patients, an
informational brochure and DVD with
tips for managing heart failure recently
compiled by a committee of clinical
experts from the Long Island Health
Network (LIHN) are just some of the
instrumental educational tools that are
provided to patients.
“Patients enjoy the educational
component of our program because it
helps them better understand their
condition; it increases compliance and
empowers patients to take an active
role in their care,” said Ms. Carman,
who served as the Winthrop representative
on the LIHN committee, and has
played an instrumental role in Mr.
Dispenzieri’s care and education.
Telemonitoring
Patients in the program are visited
periodically by a homecare field
nurse. During visitations, the nurse
performs a comprehensive physical
assessment; teaches the patient how
to use the telemonitoring equipment;
and educates them about the important
roles of medication and lifestyle
management.
“The telemonitoring program also
helps provide comfort to family members,
who can rest assured that their
loved one’s care is continuously being
monitored,” said Debra Tracy, MS,
RN, Mr. Dispenzieri’s long-time homecare
field nurse.
Patients take their vital signs each
day; the information is sorted within a
color-coded computerized system which
alerts the nurse if any information is
missing, incomplete and when there is
a need for immediate intervention. If a
patient’s vital signs flag an alert in the
system, the nurse immediately follows
up with the patient to inquire about
their symptoms.
“Sometimes, a simple retest is all
that’s needed to address the concern.
Other times, patients require care in
which case we immediately arrange
for a home visitation by the patient’s
nurse and follow up with the patient’s
physician,” said Lorraine Greene, RN,
Telemonitoring Coordinator for
Winthrop’s CHHA. Ms. Greene is one of
the nurses responsible for performing
detailed evaluations of the vitals for
the 67 patients currently utilizing telemonitoring
services.
“We know our patients well
because we deal with them every day.
Sometimes they even know it’s us calling
to check on them when the phone
rings because they learn to recognize
any variation in their health status,
and know that we will address it
immediately,” she added.
A Collaborative Approach
The strong collaboration between
Winthrop’s CHHA nurses and patients’
physicians is a vital component of the
telemonitoring program. The team
works together to rapidly address the
needs of patients before they result in
complications.
Recently, the telemonitoring program
proved its effectiveness, once
again. Upon noticing an increase in Mr.
Dispenzieri’s heart rate, weight and
blood pressure, Joanne McLean, RN,
Telemonitoring Coordinator for
Winthrop’s CHHA, called Mr. Dispenzieri
and arranged for a home visitation by
his nurse, Ms. Tracy.
Ms. Tracy immediately went into
the home to perform a full physical
assessment, and discovered an accumulation
of fluid in Mr. Dispenzieri’s
lungs. She contacted members of his
primary care team, who quickly made
adjustments to his diuretics. Just two
days later, Mr. Dispenzieri’s weight
was down and his doctor is grateful
that the Agency’s team intervened
before any complications arose.
Winthrop’s Certified Home Health Agency: Among the Best in the U.S.
For the third consecutive year,
Winthrop’s Certified Home Health
Agency (CHHA) has been recognized
among the HomeCare Elite – a compilation
of the most successful
Medicare-certified home health care
providers in the United States.
“Without a doubt, Winthrop’s Home
Health Agency team and the telemonitoring
program have helped prevent
Mr. Dispenzieri’s rehospitalization,”
said Dr. Geffken. “The constant communication
and reports that the
Agency provides keep us informed and
help us examine trends in his vital
signs and make adjustments to medications
when necessary in order to
avoid hospitalization.”
Today, as Mr. Dispenzieri continues
to utilize the program, his wife
takes comfort in knowing that her
husband’s care is in good hands.
“With Winthrop’s telemonitoring
program, there’s always reassurance
that someone is watching over you,”
she said.
Although the majority of the referrals
for telemonitoring services come
from patients hospitalized at Winthrop,
patients may also self-refer, be referred
by their physician, a family member,
neighbor or community organization, or
even another hospital.
For more information about
Winthrop’s Certified Home Health
Agency or telemonitoring services,
call 1-866-WINTHROP.
|
Vol. 20, No. 1
Winter/Spring 2010
Back to Publications
|
