Cardiac Care Program at St. Therese bridges hospital to home transition

Florence Hyser didn’t return home right away after she had aortic value replacement surgery last year at North Memorial Medical Center in Robbinsdale.

Instead, the 88-year-old Plymouth resident spent the next two months in a new Cardiac Care Program at St. Therese Care Center in New Hope.

“I knew I would need therapy, and I’m kind of used to this place,” said Hyser, who joined the St. Therese Auxiliary when the facility first opened in 1968 and was an active twice-a-week volunteer for 44 years. After undergoing surgery for a broken ankle in December, Hyser again returned to the Cardiac Care Program because of her secondary hearty-related secondary diagnosis.

The new program at St. Therese is designed to help heart patients who are discharged from the hospital receive transitional care, thereby reducing readmission to the hospital.

It is one of the first of its kind in Minnesota.

Since the program began in last May, 180 patients have participated in the program. Between 10 and 15 patients are registered in the program on an average day. Seventy percent of the cardiac patients have been female.

“Cardiac disease is the number one killer in females,” said Denise Juday Barnett, executive director at Saint Therese of New Hope.

Heart disease also remains a leading cause of death in Minnesota. The state had more than 48,000 acute heart disease hospitalizations in 2010, which resulted in more than $1.8 billion in charges for inpatient hospitalizations.

“The statistics are alarming,” Juday Barnett said. “We saw a need in the community and developed a program to uniquely serve cardiac patients.”

In  the Cardiac Care Program at St. Therese, the patients receive care from specially trained nurses and cardiac-trained rehab staff. A licensed on-site pharmacist manages medications; a registered dietitian helps with proper selection of heart-healthy food; and occupational, speech and physical therapists design routines to help patients prepare to return home.

Each patient’s stay averages 15-18 days, according to Juday Barnett.

“I have occupational therapy twice a day and physical therapy twice a day,” Hyser said. “It’s been good for me. The physical therapy department is wonderful. They have every [exercise] machine available, and you can get the same therapist every day.”

Patients’ weights and vital statistics are monitored daily, according to Katy Lee, associate director of nursing in the Transitional Care Unit.

“The team meets as a group a couple of times a week to make sure the patients are stable and to update the doctors,” Lee said.

Before they return home, patients and their families are offered nutrition education, a home visit is conducted with a licensed occupational therapist and a fitness routine is designed for the patient.

“We look at the responses to challenges we give the patients every day” said Brenda Mauthe, rehab program director. “We ask the patients how they’re feeling, we look at their cardiac responses and we work with them on breathing exercises so they can go home and return to their normal activities.”

Continued rehab for cardiac patients is available through outpatient programs once they have returned home. One of the program’s important components is a follow-up call a few days after a patient leaves and another call 30 days later.

“A nurse or social worker will check in to see how they’re doing and ask if they have questions,” Juday Barnett said. “We’ve heard some nice comments on those follow-up calls. It’s comforting for people to know there is someone to call if they have questions.”

Once Hyser has completed her stint in the Cardiac Care Program, she said, she may move to an apartment in the St. Therese complex, rather than returning to her home in Plymouth.

“We’ll be able to walk through her apartment with her to make recommendations about any changes that might be needed so she can do her activities without undue physical exertion,” Mauthe said.

A large nursing home in Bronx, New York, was the inspiration for the new program at St. Therese, Juday Bennett said, noting that some staff members from the New Hope facility visited the New York center before implementing their own program at St. Therese.

“It takes a while to develop an interdisciplinary, holistic program like this,” Juday Bennett said.

The second phase will be to implement the Cardiac Care Program at St. Therese’s Oxbow Lake site in Brooklyn Park and also through St. Therese’s home care program, she said.

St. Therese, a 268-bed care facility, opened at 8000 Bass Lake Road in 1968

 — By Sue Webber, Contributing Writer