These nurses have met with the participating cardiologists to hear first hand their requirements for what data they need regularly and when they should be called in. The nurses have even joined them on their rounds. Communication with physicians is emphasized and facilitated with the standardized note. For example, congestive heart failure patients have their electrolyte levels continually monitored, and that information is faxed directly to their physician. This system has been set up so we can provide information specified by the doctors on a real-time basis, the same day as the visit.
Communication is much tighter.
At the same time, the protocols call for care that's much more timely and intensive than that typically provided at home, Eulberg says. Nurses typically are in the patient's home within hours of their return from the hospital, even if that's late at night. Nevertheless, he notes, insurers and others continue to try to cut lengths of stay without the necessary systems in place to ensure against complications and poor outcomes. Our statistics are going to be better than those for patients that are just being thrown out of the hospital without any follow-up. Indeed, outcomes analysis is a critical part of the project.