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The High Tech Heart: Complex Cardiac Cases with an Approach that Focuses on the Comfort of the Patient and Family

separator Patients who need complex cardiac treatment usually have two main expectations for their care:

  • That it will be at a hospital offering the very latest in advanced technology
  • That the care will offer them and their families the comfort and personal touch they need

Very often, it's difficult to find both in the same facility. But at Mercy Hospital Anderson in Ohio, heart patients can rest assured they'll have the benefit of everything cardiac technology has to offer while they receive care that focuses on keeping them—and their families— as comfortable and confident as possible.

Denise Rivera, R.N., Manager of the Cardiac Cath Lab at Mercy Anderson, says, "We started our cardiac program in February of 2006. We had tremendous community support for this. Patients want to know they're going to be getting the kind of cardiac care they can get at the bigger hospitals downtown, but they don't want to have to go downtown to get it. They love it that they can stay in their community. They feel safer here, and they get everything they need."

Cheryl Smith, R.N., says, "All the physicians here also go to the the larger downtown hospitals, so patients are getting the best of both worlds."

Mercy Anderson's cardiac program subscribes to the newest concept in cardiac care, called the "universal bed concept." Kathi Edrington, R.N., Manager of the ICCU/CCU, says, "It's the newest and most popular way to care for heart patients. Patients go straight from the operating table to recovery, and they continue to receive care all in one place. There's no 'step down' unit, where they have to go somewhere else for care after the surgery."

Patients love the universal bed concept, says Rivera, because they have the same staff with them both before and after surgery. "This is comforting and reassuring for patients," she says. Patients do so well in this scenario, with its emphasis on continuity of care, Rivera says, that they're often able to leave the hospital and return home in 4 or 5 days.

Edrington explains that this new approach is beneficial not just for patients, but for the staff who care for them as well. "For the majority of my career, I used to send patients out for high level acute care. They often had to go to another hospital." Now, she says, she finds it extremely rewarding to see a patient from the beginning of their hospital stay until they go home.

Multiple procedures, with a quick return home whenever possible

It's not uncommon for a patient to need more than one heart procedure in one hospital stay, which requires open communication among the different physicians who are providing treatment. The many specialists in the cardiac program at Mercy Anderson collaborate closely with each other and with other staff in the program to coordinate complex patient care. "Every person who will be involved in a patient's care is notified so that they can be prepared to receive that patient," says Rivera.

One recent patient, Mr. Smith (not his real name), came to the hospital to see his doctor because of chest pain. It was 9:00 on a Friday morning. He had an emergency catheterization at 9:30. Doctors determined that Mr. Smith needed coronary bypass surgery, but before they could perform that, they needed to remove blockages in his carotid artery. That was done at 1:30 the same Friday.

The following Monday, Mr. Smith had bypass surgery, and he was discharged from the hospital the following Friday, only one week after his arrival. Denise Rivera says, "Mr. Smith told us the other day that he's feeling better than he's felt in a long time. He's able to play with his grandchildren now. The treatment he received here greatly reduced his risk of having a heart attack or stroke."

Involving families in education about care

The staff of the cardiac program educates places a heavy emphasis on educating patients' families about what to expect after surgery. "We send teaching packets home with families," says Smith. "Patients also get a book telling them what the heart is, how it works, what the surgery will be like, what medications they'll have to take.

"Our recovery nurses do a lot of teaching with patients and families. We tell them what to expect from the whole process, from beginning to end.

"Staff at the pharmacy help as well," continues Smith. "They explain to the patient and family what the medication schedule will be, how to take the medications and whatever else it is that patients need to know. And they provide the medications right here, so patients can go directly home with them."

After patients go home, there's comprehensive follow-up. Even outpatients receive a phone call every three days. "We ask them how they are, how they feel and what we could have done better," says Rivera. "If someone says their leg hurts but they're reluctant to call the doctor, we make the call. We close the circle for the patients."

A happy hospital staff provides the best kind of care

It's no secret that when hospital staff enjoy their work, they provide the best patient care. The staff in the heart program at Mercy Anderson has extremely low turnover, and there are very few job openings. Many employees have been there for 16 years or more.

"My staff is so excited we have this program," says Rivera. "The pride we have is unbelievable. We've built a program that competes with the hospitals downtown."

"We didn't like sending patients away before," says Smith. "It's so gratifying now."

"Even on our busiest days," says Rivera, "you see RNs rubbing the backs of patients."

Personal Interviews, Kathi Edrington, R.N., Manager, ICCU/CCU; Denise Rivera, R.N., Manager, Cardiac Cath Lab; Cheryl Smith, R.N.
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