The first two months after the December holidays are when nurse Nancy Brass-Mynderse knows she’s going to start seeing all her heart patients.
“They’ve spent December eating everything they’re not supposed to including candy, pies and salty snacks,” said the nurse practitioner at Scripps Clinic in La Jolla." Then in January and February, they all call in complaining of shortness of breath, swelling in their legs, and overall fatigue."
But thanks to the Scripps Clinic Congestive Heart Failure Clinic, patients can get an appointment, medication or other help they need immediately, without having to wait to see their internist or a cardiologist. The clinic even takes walk-in patients who need urgent attention. Nancy and her nursing partner see about 100 patients a week in their office at Scripps Clinic’s La Jolla site, and care is covered by various insurance plans.
Scripps Clinic opened the Congestive Heart Failure Clinic in 1996, when physicians found that many patients with heart problems were not getting healthy after being discharged from the hospital. The readmissions were costly, and often patients did not improve. Then the doctors hit on the idea of having nurse practitioners run a clinic so patients could be monitored on a regular basis and learn about the things that would really improve their health.
“We teach them how they can use diet, exercise, blood pressure checks and their medications to control their condition,” the nurse said. “If they are educated as to what heart failure is and how to control it, they can be the best managers of their own condition.”
Encinitas resident Jack Broward is one Scripps heart patient who credits his health to the CHF Clinic. At 77, Broward still works as a part-time newspaper columnist after three heartaches. “I’ve been able to continue my work as a journalist thanks to care and monitoring from the clinic,” said Broward, who visits for monthly check ups.
The idea has been so successful that Scripps Clinic now has Congestive Heart Failure Clinics at three sites: La Jolla, Encinitas, and Rancho Bernardo. According to the American Heart Association, the national readmission rate in a 30-day period for CHF patients is about 25 percent. But Scripps Clinic’s readmission rate is only 2 percent.
“Our efforts have resulted in a dramatic decrease in the need for hospitalizations among the elderly with weaker hearts,” said David Rubenson, MD, chief of staff at Scripps Green Hospital, who works with nurses at the heart clinic.