Home protocols essential for heart patients - 13 WTHR Indianapolis

When heart patients are in the hospital their caregivers follow precise protocols. But when the patient is discharged, they often head to rehab or home where the routine can be dramatically different.

That gap in care puts patients at risk. Dr. Waquas Ghumman at Community Health Network hopes to improve outcomes with a new continuity of care program that he authored for congestive heart failure patients.

James Lynch is one of the first patients to benefit from Ghumman's plan. Every day, twice a day, Lynch is in therapy working on his strength and balance.

"I'm low on my balance right now. I'm just I'm real unsteady on my feet," Lynch said. He is determined to reach his goal in Rehab at Rosewalk. "I want to be able to walk out of here on my own. I don't want a walker. I want to be able to do it by myself," Lynch said.

It's what his medical team wants too.

Dr. Ghumman partnered with American Senior Communities this year in hopes of improving patients outcomes. He shared the hospital protocols for weight, diet, and medicine.

The patient instructions are laminated and color coded with an action plan based on symptoms. They are posted in the patient's room. The transparency leads an increase in care consistency.

Ghumman says the message to patients should be clear.

"You are always a part of our system and we care about you irrespective of whether you are in the hospital or not," Ghumman said.

"It needs to be consistent because one of the things that we do poorly is that when the processes are different at one institution versus another we give a different mixed signal to patients that this is acceptable when it's not, " he added.

Lynch reviews the patient instructions. He sees his weight is steadily dropping and that he's on track.

"I'm probably right now in the green zone. I don't have any shortness of breath," he said. For Lynch the action plan is to be diligent with medication even when symptoms subside.

Ghumman says this patient population has to be reminded time and again that the must stay on their prescriptions even if their symptoms have subsided.

"If you don't have fluid, it doesn't mean that you are cured. You are not cured. As a matter of fact, the heart is continuing to get bigger and weaker. What you have to realize is that these medicines are preventing that progression and slowing it down and so that is kind of one of the skill things that we have to teach patients is that adherence to these medicines translates to their survival," the doctor explained.

Lynch is following orders. And while in he rehab he looks forward to visits with grandson Anthony who brings the mail from home. But a bigger thrill, Lynch says, will be when he can walk to the mailbox and get it himself.