Montefiore Heart Followups Trim Readmissions

You’d be mad at having to return your car to the mechanic within a month, yet rehospitalization after people get their hearts repaired too often is treated as business as usual, laments Dr. Ricardo Bello, a cardiac surgeon at New York’s Montefiore Medical Center.

Heart surgeons try to prevent that by re-examining patients two to three weeks after they go home. But Montefiore patients tend to be readmitted sooner than that.

So last fall, Bello’s team began a special clinic where nurses check heart surgery patients about a week after they go home, at no extra charge — and have a chance to re-teach those discharge instructions when people are more ready to listen.

Plus, for that first month at home, patients are supposed to wear a bracelet with a phone number to reach Montefiore’s cardiac unit 24 hours a day with any worries.

“It changed my conception of dealing with a doctor,” said Michael Lee, 60.

Montefiore surgeons repaired a life-threatening crack in Lee’s aorta, the body’s main blood vessel, but his recovery derailed days after getting home. He quit some medications. He was scared to wash the wound that ran from chest to navel, an infection risk. He developed a scary cough and called that special clinic in a panic.

It turned out the cough was a temporary nuisance — but nurses discovered a real threat: Lee’s blood pressure was creeping up, a risk to his healing aorta. Those pills Lee quit were supposed to keep it extra low, a message he’d missed. And some hands-on instruction reassured Lee that he could handle his wound without tearing it.

Without the clinic, “he’s definitely somebody we would have been called to see in the emergency room,” said physician assistant Jason Lightbody.

This article appeared in print on page 5 of the February 12th, 2013 edition of Hamodia.