Being admitted to the hospital can be a frightening
experience for some but for others, leaving the hospital
causes more anxiety.
While in the hospital, a team of health care
professionals monitors a patient’s condition hourly
and, at times, even more frequently. They provide
care, guidance, instruction and support for each
individual’s specific health needs.
But when a patient leaves the hospital, they may not
have a strong support system in place to keep them
on track to reaching their optimum level of health.
If they don’t take their medication, improve their
diet or get check-ups, they might end up back in the
hospital or the emergency room.
The new Stay Healthy Clinic at Barnes-Jewish Hospital,
which opened in September 2011, is designed to fill
the gap when a patient needs help staying on the right
track. Patients who are identified during their hospital
stay as vulnerable—they have a diagnosis of heart
failure, pneumonia, chronic obstructive pulmonary
disease (COPD) or have had a heart attack and their
social situation puts them at risk to return—are given
an appointment in the clinic within a week of their
initial discharge. Transportation and cab vouchers
are available for the return visit.
Henish Bhansali, MD, a Washington University
physician who runs the clinic, reviews each patient’s
record thoroughly to understand what happened
during the hospital stay. He and nurse practitioner
Kelly Dodds, RN, ANP-BC then meet with the patient to
see if the patient understands and has been following
discharge instructions, verify all of their medications
and answer any questions.
On a recent visit, Barbara Buckley discussed symptoms
that she had been experiencing with Dr. Bhansali.
Buckley suffers from a heart condition that has
caused her to be hospitalized more than once.
In addition to the Stay Healthy Clinic, Barnes-Jewish
has launched several programs to reduce patient
readmissions. In some instances, nurses make home
visits to released patients, helping them to set up pill
boxes and coordinate their medications. The clinic
could eventually see up to 50 patients a week for
follow-up appointments.
After addressing any lingering concerns from a
patient’s hospitalization, the goal of the clinic is to
connect each patient with a medical home, such as a
family physician. “We have the chance to spend a lot
of time with patients at the Stay Healthy Clinic, so
we can truly get to the core of not only their medical
issues but also their social issues. This is the part
that I feel has the strongest impact on their overall
medical care and outcomes,” says Dr. Bhansali.