PHC Plays a Key Role in Partners Heart Failure ProgramOver the past year, Partners Home Care has been actively involved with Partners HealthCare System's Heart Failure Clinical Summit in the development of a Heart Failure Program for PHS's Disease Management Signature Initiative IV. The goal of this Heart Failure Initiative is to provide premier care for high-risk patients while integrating Heart Failure interventions across PHS's entire continuum of care. Represented by Judy Flynn, RN, Vice President of Performance, Education and Quality Improvement, and Kathy Duckett, RN, Director of Clinical Programs, Partners Home Care is pleased to play an instrumental role in the development of this significant program. The primary objective of the Heart Failure program is to develop a multilevel approach to post-acute care for heart failure patients that ensures every patient receives the most appropriate complement of services on an ongoing basis. This approach promotes coordinated access to PHS's Heart Failure programs that are geared to patient self-care management and compliance with the medical regimen. The overall design promotes wellness and support through the integration of services offered by Partners Home Care, the PHS Cardiac Nurse Practitioner network, and Partners HealthCare Connection. Partners HealthCare Connection, a call center for high-risk patients, has selected Partners Home Care's Social Work team, led by Marla Kaplan, MSW, to assist in dealing with patient concerns arising from call center interventions. The Connection serves patients with Heart Failure as well as other high-risk diagnoses. The Heart Failure program is also creating ongoing cardiac education and system-wide interface across PHS's continuum of care. For example, Partners Home Care is developing patient education materials that reinforce and enhance the training that Heart Failure patients receive during their PHS hospital experience. Additionally, a system-wide interface among Partners Home Care, PHS's Heart Failure Program, and the Signature Initiative Complex Case Management Program is incorporated throughout the program. ©2005 Partners Home Care, Inc. All rights reserved. Privacy | Disclaimer | Copyright |