NIH funded study: nurse-led care coordination significantly improves care of heart disease in western Wisconsin
MINNEAPOLIS — A study funded by the National Institutes of Health found that the number of patients with heart disease who received optimal care increased by 49 percent when a nurse-care coordinator team managed the care. Research by the HealthPartners Institute for Education and Research and collaborators in western Wisconsin shows that care coordination increased the number of patients who received all elements of recommended care: blood pressure <140/90 mm/Hg; low-density lipoprotein (LDL or ‘bad’) cholesterol <100 mg/dL; took aspirin daily (unless contraindicated); and did not use tobacco.
Outcomes for patients with diabetes but not heart disease (the comparison group) also improved during the study period. Heart disease is the leading cause of death in the United States for both men and women, but most patients do not achieve all the elements of optimal cardiac care.
Care coordination involves a nurse or medical assistant working with a patient to overcome any barriers to care such as identifying community resources that could benefit patients and families (e.g., transportation, home care); serving as a liaison between patients, their families and their healthcare team; and ensuring that patients receive all needed services and care.
The study looked at about 1,000 patients with coronary heart disease and took place from 2011-2013 at Hudson Physicians, Westfields Hospital and Clinic; and River Falls, Ellsworth and Spring Valley Medical Clinics. In addition to improved care, the study also showed that staff satisfaction increased significantly, while patient satisfaction remained high.
“Social needs can be a barrier to patients getting needed care,” said Tom Kottke, MD, principal investigator and medical director of population health at HealthPartners. “This study shows that care coordination can remove those barriers to care.” “We find our care coordinators are a critical bridge between our patients, their families, community and providers,” said Paul McGinnis, MD, coinvestigator at Hudson Physicians. “This is a real-world example of how care coordination can make a difference.”
All patients with heart disease seen by primary care providers at one of the five clinics received extra services during the study period.
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About HealthPartners Institute for Education and Research
Minneapolis-based HealthPartners Institute for Education and Research is a 501c (3) nonprofit organization dedicated to improving health and well-being in partnership with its members, patients and community. Researchers conduct public-domain health research proposed and led by teams of PhD- and MD-level investigators. Our health professional educators provide accredited graduate medical education and clinical simulation that emphasizes quality improvement and experiential learning. Hudson Physicians, in Hudson, WI, is a team of primary care providers and staff brought together by our devotion to treating patients individually and personally. The team’s medical expertise ensures that the community can expect an unparalleled level of care.