title: Home visits keep CABG patients out of the hospital.
abstract: In a pilot study, coronary artery bypass grafting surgery patients who were in North Shore University Hospital's Follow Your Heart program had a 3.85% 30-day readmission rate compared to a 11.54% rate for at-risk patients not in the program. Cardiac surgery nurse practitioners visit at-risk patients at home after discharge, conduct a physical exam, performed medication reconciliation, and educate patients on signs and symptoms that indicate they should call their doctor. They collaborate with the home health nurses, informing them about what happened during the hospital stay and sharing other information that might not be on the discharge summary. They send a report of the visit to the patient's primary care physician, surgeon, and the home health agency.
mesh_terms: D003266:Continuity of Patient Care; D001026:Coronary Artery Bypass; D006792:House Calls; D006801:Humans; D009518:New York; D064691:Nurses, Community Health; D010359:Patient Readmission