In 2016, North Georgia Health Systems in Gainesville, Georgia opened the Woody Stewart Advanced Heart Failure Treatment Unit (WSHFTU).
The 16 bed unit is named for the late Woodrow “Woody” Stewart. Stewart served as chairman of The Medical Center Foundation from 1998 until 2012.
Because WSHFTU is unique in the state and only one of four units in the entire nation to provide pulmonary artery monitoring outside of the critical care unit we questioned several staff members and a patient about what WSHFTU offers and what makes it different.
Regina Dryden, BSN, RN, CHFN, Charge Nurse, Woody Stewart Heart Failure Unit explains the difference between the heart failure unit and more traditional cardiac rehab programs.
Dryden says that in more traditional scenarios, heart failure patients would require critical care services. Then 6 weeks after optimization of medication therapy a cardiac rehab program would be initiated. There would be customized exercise plans to improve symptoms and function along with blood pressure and heart rhythm monitoring.
By contrast, she explains, “The staff on WSHFTU are specially trained on care and treatment of heart failure patients including intravenous diuretics, critical intravenous medication drips, and specialized monitoring catheters placed within the heart, to improve symptoms and allow the patient to return home.”
Dryden adds, “Everything on the unit (WSHFTU) is designed to empower the patient and their family to manage symptoms at home, when to call the doctor for worsening signs of heart failure and lifestyle modifications needed to live life successfully with heart failure.”
For example, Dryden says that dietary slips are included on the patient’s food tray with sodium and fluid amounts in each item. This is a teaching tool for the patient and their family in learning how to manage dietary restrictions.
Larry Warren, a former patient on the unit says that he and his wife learned a lot about preparing food and tracking sodium during his stay.
He says, “It was interesting to learn that some spices like Mrs. Dash do contain sodium. We were given a list of spices that were good to use in place of salt.”
Another example of patient empowerment is education on medication management. The patient and their family are taught why certain medications are prescribed, potential side effects as well as when and how to take them.
According to Eva Johnson, MSN, ANP-BC, ACNP-BC, CHFN, Heart Failure Disease Manager for NGHS, another focus of WSHFTU is patient transition from inpatient to outpatient care.
She says that this is achieved by rounds from a Daily Interdisciplinary Team.
She explains, “Daily Interdisciplinary Team (IDT) rounds on WSHFTU include the following disciplines: Heart Failure Case Manager, Social Worker, Chaplain, Pharmacist, HF Disease Manager/Nurse Practitioner, WS Charge Nurse and nurse caring for the patient.”
“IDT rounds begin on admission date, are conducted daily to assess patient/family/caregiver needs, to ensure a safe and successful discharge to home. Research reveals psycho-social needs that are not addressed during hospitalization can lead to early hospital readmission.”
She says that case managers and social workers are utilized to assist patients in accessing the community resources they need for affording medications, food, housing and transportation to follow-up appointments.
Warren notes that when he was a patient, one of the great features of WSHFTU was the fact that each nurse had their own phone. He says that it made it so much easier to reach his personal nurse rather than relying on the call button to reach whomever was available at the desk.
A premier feature of WSHFTU is the Nathan-Schrage Teaching Center with demonstration kitchen.
Pam Williams, BSN, RN, Coordinator of Heart Failure Support Services says that this state-of-the-art facility allows Heart Failure Educators to provide the necessary tools for the patient, their family and caregivers to manage heart failure at home.
She explains, “Treatment of heart failure requires patients to undergo lifestyle modifications in dietary restrictions of sodium and fluid intake, dealing with decreased exercise capacity, preventative care, and changes in medical therapy and overall monitoring of symptoms. These interactive classes review disease process, medical treatment and lifestyle modifications needed to be successful.”
“The demonstration kitchen teaches patients (that) healthy food choices to manage heart failure, can also taste good. These classes are promoted to patient rooms if they can’t attend class and in the future will be available via podcast for family members who can’t attend class.”
In addition to education, support services also monitor patients via telephone for 30 days post-hospitalization. This helps identify patients who need to see the medical provider for symptom management.
Williams says, “Outpatient Diuresis Service allows medical providers to refer patients for outpatient administration of intravenous diuretic and patient education with 30 day telephone monitoring.”
“Both Heart Failure Support Services and Outpatient Diuresis Service decrease Emergency Department visits, subsequent hospitalization, improving patient outcomes and quality of life.”
Successful heart failure management is measured by 30-day readmission rate and mortality rate. NGHS’s rates rank among the best in the country.
Williams credits the team approach which includes not only the patient but their family and caregivers. This improves compliance which decreases hospitalization and mortality rates.
She says, “Heart failure is a chronic disease with no cure, but quality and longevity of life is improved by medical treatment, compliance with medical therapy and dietary restrictions, implanted devices such as an implanted defibrillator for those with potentially fatal heart rhythms or a left ventricular assist device (LVAD) that assists the heart in circulation of blood flow. Research shows that by 2030, 1 in 5 Americans will be living with heart failure. Currently, CMS and private payers spend more for heart failure treatment than all cancers, stroke and heart attacks combined.”
Larry Warren also feels that in addition to all of the specialized training and technology available to patients at WSHFTU, it is the human touch that really makes a big difference.
He says, “The nurses were great. Very attentive. It was an excellent experience. I’m pleased. So very pleased.”
