Ochsner Transitional Care Clinic focused on heart failure leads to significant improvement in patient outcomes

Some 1.1 million Americans are hospitalized each year with congestive heart failure (CHF), and the average hospitalized patient faces a one-year mortality of 30 percent and a readmission rate of 50 percent at six months. With this deadly disease as its top readmission diagnosis, Ochsner Health created a Transitional Care Clinic in October to reduce readmissions and, ultimately, improve the quality of life and survival of these patients. Since then, the clinic has reduced CHF readmission rates by three percent, caring for more than 300 patients post hospital discharge.

“CHF is prevalent across the Gulf South, where risk factors, such as high blood pressure, diabetes and obesity, are high. To address the needs of our population, Ochsner created this clinic to focus exclusively on CHF patients and closely guide them to healthier outcomes,” said Dr. Sapna Desai, an advanced heart failure and cardiac transplantation specialist who heads up the Transitional Care Clinic. “In just six months, we’ve seen a significant reduction in readmissions, showing this approach is working.”

Focusing on patients with a diagnosis of acute decompensated heart failure due to reduced left ventricular systolic function (CHFrEF), Ochsner’s Transitional Care Clinic is ensuring the institution of guideline directed medical therapy (GDMT) and referring appropriate patients for placement of an automatic implantable defibrillators, for cardiac resynchronization therapy and to the Heart Failure Transplant Service. It is also educating patients and caregivers on CHF and its treatment, including GDMT, dietary restrictions and targeted activity levels.

“We’re giving our patients special attention, sitting down with them regularly to discuss, in detail, the causes of their heart failure, their individualized treatment plans, and the steps they can take to get healthier,” said Dr. Desai. “Treatment for acute diagnoses can be quite complex, and so, this level of care is helping patients stay on track and out of the hospital.”

Ochsner has the largest program for advanced heart failure treatment in the Gulf South, and its patients receive the latest treatment options and personalized care. Ochsner offers a complete array of innovative technologies, including surgical and percutaneous implantable mechanical support, implantable hemodynamic monitoring, biventricular pacing, ultrafiltration and novel drug therapies.

For more information or to make an appointment with an Ochsner cardiologist, please visitwww.ochsner.org/cardiology.