title: Impact of a nurse-managed heart failure clinic: a pilot study.
abstract: BACKGROUND
  One approach to optimize clinical and economic management of congestive heart failure is the use of multidisciplinary outpatient clinics in which advanced practice nurses coordinate care. One such clinic was developed in 1995 at a southeastern university hospital to enhance management of patients with chronic congestive heart failure.
  
  
  OBJECTIVE
  To evaluate the effects of a multidisciplinary outpatient heart failure clinic on the clinical and economic management of patients with congestive heart failure.
  
  
  METHODS
  Data on hospital readmissions, emergency department visits, length of stay, charges, and reimbursement from the 6 months before 15 patients joined a heart failure clinic were compared with data from the 6 months after the patients joined the clinic.
  
  
  RESULTS
  The patients had a total of 38 hospital admissions (151 hospital days) in the 6 months before joining the clinic and 19 admissions (72 hospital days) in the 6 months afterward. The mean length of stay decreased from 4.3 days in the 6 months before joining to 3.8 days in the 6 months afterward, and the number of emergency department visits also decreased, although neither decrease was statistically significant. Mean inpatient hospital charges decreased from $10,624 per patient admission to $5893. Reimbursements were $7751 (73% collection rate) and $5138 (87% collection rate), respectively.
  
  
  CONCLUSIONS
  Patients seemed to benefit from participation in the heart failure clinic. If a healthcare provider is available to manage early signs and symptoms of worsening heart failure, hospital readmissions may be decreased and patients' outcomes may be improved.
authors.affiliation: Heart Failure Clinic, Medical University of South Carolina, Charleston, USA.
authors.forename: S
authors.initials: S
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000451:nursing*; D017722:Hospital Charges / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000458:organization & administration*; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration; D010358:Patient Participation; D010865:Pilot Projects; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D015144:Southeastern United States