Member tool spotlight: NHRMC's heart-healthy holiday greeting card

New Hanover's holiday greeting card keeps HF patients home for Christmas

By Daniel Roza, Senior Analyst

As the number of heart failure patients continues to rise and financial pressure to improve quality outcomes increases, it is more important than ever to develop cost-effective, cross-continuum methods of managing heart failure patients.

This year, our research uncovered best practices to build a next-generation heart failure program through improving outpatient care. As we presented the research throughout the national meeting series, one case in particular consistently stood out as an audience favorite by virtue of its simplicity and effectiveness. As you continue to confront the challenges of managing heart failure patients, we hope this best practice may inspire action:

HF programs experience the "holiday-spike"

Most CV programs have invested in strategies to help transition heart failure patients back home well-equipped to manage their conditions. However, many patients still struggle with self-management.

As a case in point, many programs admit to experiencing a “holiday spike” in readmissions—the period between Thanksgiving and Christmas when patients consume holiday foods high in salt and fats that may lead patients to decompensate and require a hospital admission. New Hanover Regional Medical Center was familiar with the holiday spike but was determined to reduce the negative impact on patients.

New Hanover's approach to at-risk patients

In New Hanover’s case, the HF program manager who identified the annual spike presented her data to New Hanover’s CHF steering committee. Together, the steering committee developed a holiday diet education campaign that consisted of sending a heart-healthy holiday informational greeting card to at-risk patients.

To minimize costs and maximize results, New Hanover targeted its greeting card campaign to the highest-risk patients. Data analysis revealed three subsets in particular that were vulnerable to the holiday spike: patients who demonstrated a history of frequent admission, patients previously admitted during the holidays, and patients with recent readmissions. Using this analysis, New Hanover Regional Medical Center identified 71 patients who could benefit from the additional support of this initiative.

In designing the campaign, New Hanover felt it was important to ensure the greeting card matched the unique needs of the patients it served. Rather than replicating American Heart Association (AHA) dietary guidance, the card offered heart-healthy recipe modifications of a dish popular in the region. New Hanover was also sensitive to the socioeconomic needs of their targeted patient population and made sure that all suggestions were written for clarity and affordability.

Importantly, New Hanover realized that the design of the mailing would in part determine if the recipient read it, rather than throw it away without a glance. As such, each envelope was addressed on stickers, rather than directly on the envelope, and included a handwritten note to set the card apart from other hospital correspondence. Additionally, the program manager’s business card was included in each envelope in case the patient wanted to reach out with questions.

In the year New Hanover sent greeting cards, they achieved their lowest December readmission rate in four years. In fact, of the 71 patients who received the card, only two were admitted for heart failure-related causes. These results came from the population most at risk, making it all the more meaningful for program administrators.

Based on the success of this initiative, New Hanover is considering expanding the strategy to other patient populations and other times of year when patients are at greater risk of ending up back in the hospital.

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