cardiology inpatient nurse practitioner service- vision to reality
DESCRIPTION
Cardiology Inpatient Nurse practitioner Service- Vision to reality Suzanne Waters, MSN, FNP, Maheswari Murugesan, MSN, ACNP-BC, Emily Koch, MSN, ACNP-BC, Cyndi Loffler, MSN, ANP-BC Department of Cardiology, University of Virginia Health System. Vision and Reality . Outcomes. - PowerPoint PPT PresentationTRANSCRIPT
Cardiology Inpatient Nurse practitioner Service- Vision to realitySuzanne Waters, MSN, FNP, Maheswari Murugesan, MSN, ACNP-BC, Emily Koch, MSN, ACNP-BC, Cyndi Loffler, MSN, ANP-BC
Department of Cardiology, University of Virginia Health System
Vision and Reality The inpatient Nurse practitioner (NP) Cardiology service was created and implemented in March 2010 with a vision to enhance care for the acute cardiology patients .
Scope of servicePatients with a set plan of care and estimated stay of not more than 96 hours (exceptions do apply) may be admitted to the NP service.
All Electrophysiologists( EP), Interventional Cardiologists, ACS Attending and EP and Cardiology Consult Attendings and Valve Attendings admit patients to NP service.
Accept outside hospital procedure related transfers (both Cardiology and Electrophysiology)
Service Admission and discharges from 2010-present Admissions in 2012 by Specialty
Inpatient NP service monthly activity
Service Coverage One Nurse practitioner is available from 7.00 A.M- 07:30 p.m on Weekdays and 7:00 A.M to 12:30 p.m on the weekends.
The service is covered by the Cardiology Consult Fellow after 07:00 p.m on the weekdays and after 12:00 Noon on the week ends
Maximum Census per day does not exceed five patients per day.
Admissions are accepted from 07:00 A.M to 05:00 p.m on the weekdays.
Patient population managed by the Nurse Practitioners
NSTEMI, Stable and Unstable Angina, Syncope, Brady and tachy-arrhythmias, ICD and pacemaker device related infection and malfunction, Valve disorders, Heart failure, Anti-arrhythmic drug loads
OutcomesI
Acknowledgements
To all our Nurse Practitioner colleagues, Attending physicians, Fellows, Nurses and all other Staff in the Department of Cardiology for their continued trust, collaboration and contributions to the growth of the service
Press Ganey results
Physician Discharge Personal Issues
Overall Assess-
ment
76
78
80
82
84
86
88
90
92
4 East Patient Satisfaction Scores
2009 Pt Sat Scores Prior to Start of NP Inpt Service
UVA Pt Sat Score 2010
AHA Pt Sat Benchmark 2010
Pt Satisfaction Categories
Pt S
atis
fact
ion
Scor
e
Physic
ian
Discha
rge
Perso
nal Is
sues
Overa
ll Ass
essm
ent
72.0
74.0
76.0
78.0
80.0
82.0
84.0
86.0
88.0
90.0
92.0
4 Central Patient Satisfaction Scores
2009 Pt Sat Scores Prior to Start of NP Inpt Service
UVA Scores 2010
AHA Benchmark 2010
Pt Satisfaction Categories
Pt S
atis
fact
ion
Scor
e
2010 2011 2012
Average Daily Census
1.74-3.19(2.5)
2.24 1.2 – 3.8(2.5)
Maximum Daily Census
5 5 6
Monthly Inpatient Discharges
12- 23(18)
9 – 21(15)
5- 15(10)
Monthly Outpatient w/e Discharges
1-9(5)
3-14(9)
6-14(10)
Eliminated capping of admissions to the Acute cardiology serviceSolution for ACGME restrictionsPress Ganey Scores and physician satisfaction consistently goodCompliance with “core measures” 100%NP documentation compliance with coding/ billing and core measures =100%Improved access to care with expanded hours (7am – 7pm)Highest DRG’s: EP,Cardiac catheterization, heart failure and valvular diseasesNew Valve service to be createdAll outpatient weekend discharges done by NP’sAttendings are referring patients directly to NP service