The Home Heart Health (HHH) pilot program was created with the intent of delivering adapted cardiac rehab services to homebound patients through home care clinicians. The increasing emphasis on care coordination and transitional care, coupled with the low attendance and utilization rates of outpatient cardiac rehab, exemplified the need for alternate models of cardiovascular care delivery. We are very excited to announce that feedback from patients and clinicians was overwhelmingly positive!
Our team has been incredibly busy over the past few months, as we finishing up patient recruitment into our study and focused on the analysis. We surpassed our patient recruitment goal into our study! As we devote our time at the end of this project grant and beyond to the evaluation, the best way to evaluate a patient-driven model is to ask the patients themselves! Check out some direct quotes from our patients below:
“I was shocked to find out that there was something wrong. And, initially, I didn’t hear that from any medical person [in the hospital]. It was like chatter, but it became evident that everybody knew it but me. Nobody sat me down and said, ‘Okay, we’ve done all these test and we know that you have congestive heart failure.’ [My HHH nurse] was the first medical person who spoke to me about it. [My HHH nurse and rehab therapists] were all very kind and very understanding and very helpful, very, very helpful.” – HHH patient
“I don't use salt that much at all because [my VNSNY nurse and rehab therapist] tells me not to use salt. [My HHH nurse] told me about canned soups and things that contained a lot of salt in them, and not to eat any soups in a can, no processed foods, and I just stick with turkey now, chicken fish, and things like that, where I used to buy salami and cheese. Now I don’t buy any cheeses at all, and that works very well.” –HHH patient
“Frankly, I did not think my heart was something that I had to concern myself with. I know I had a kidney that was functioning less than at par and the question of heart came up during the examination. Evidently, I have some heart condition, and it has become more pronounced recently. [My HHH nurse and rehab therapist] make me feel comfortable and the information that they provided me was excellent.” – HHH patient
“My legs were very weak when I got out, and [my HHH rehab therapist] gave me these legs exercises, and now it's built up my leg strength, so now I could stand. I had trouble even standing up, for a long time, to shave or things such as that. Now I can stand up for long periods of time with no problem. She straightened my legs. My breathing improved greatly with her.” –HHH patient
“The breathing exercise was particularly helpful because [my husband] does have some heart congestion situation. The deep breathing, [the HHH rehab therapist] was particularly [helpful]. We do it now with him. The deep inhale, just every once in a while when he gets short of breath, that he will do the deep breathing in and the out, and in up through the nose. That was very good, to institute now when he gets short of breath, which he does occasionally.” – caregiver of HHH patient
“The nutrition [sheet] is in the kitchen. I definitely [refer to it]. In the kitchen, I make sure that I am aware, don’t take for granted that I understand all the food concepts. The whole idea of a disciplined life, it’s a new awareness.” – HHH patient
Lastly, we are in the process of determining the best approach for expanding the interdisciplinary training throughout our partner agency. With the final evaluation complete, and the results overwhelming positive, there is a strong interest to launch the program throughout the entire agency. At our strategic meeting in June, we developed a plan to expand the training and program. We also determined goals for aligning with the education department and are planning to be on the schedule of trainings for 2017. Finally, we have taken steps to determine a point person for this project. To have a plan in place for HHH expansion within the largest not-for-profit home care agency in the nation is an incredible project feat.
In short, the Home Heart Health represents a novel approach to increasing accessibility and utilization of cardiac rehab services, and improving the continuum of cardiac care. This program is unprecedented in that it uses home care clinicians to deliver adapted cardiac rehab services to patients with cardiovascular disease. Our next steps include expanding the program throughout the agency and further studies to evaluate program efficacy. Our mission is to increase accessibility and utilization for cardiac rehab services, and transform the culture and care delivery for patients!
Stay tuned for exciting news about our project dissemination and complete analysis --> Coming soon!