New medicines, a new diet, major lifestyle changes. It’s no secret: Congestive heart failure treatment can be complex and overwhelming.
To help patients diagnosed with congestive heart failure or cardiomyopathy, University of Minnesota Health created the C.O.R.E. Clinic for Heart Failure Management. C.O.R.E. stands for Cardiomyopathy Optimization, Rehabilitation and Education. The program supports heart failure patients as they make necessary lifestyle changes in order to stay healthy and stay out of the hospital.
We spoke with Nurse Practitioner Kristine Mannchen, MSN, CNP, the C.O.R.E. Clinic program director, about the clinic and how it aids patients.
Our cardiologists, nurse practitioners, physician assistants and nurses partner with heart failure and cardiomyopathy patients to improve their quality of life and to keep them from going back to the hospital repeatedly. After an initial evaluation, we manage their symptoms by optimizing their medications and, in some cases, helping rehabilitate them. Finally, we educate each patient so that they have the tools to recognize their symptoms and get help before they need hospitalization. Each person in our program receives a treatment plan and works one-on-one with a C.O.R.E. nurse to learn more about their symptoms and medications.
Patients with congestive heart failure or cardiomyopathy have a condition that reduces the heart’s ability to pump blood as effectively as a healthy heart. Over time, the condition can get worse. With rehabilitation, we try to slow or reverse the progression of the disease and improve heart function. We use medications and teach them how to help themselves. When appropriate, we may enroll them in cardiac rehabilitation for exercise, because exercise can help the heart work better.
Usually, we see patients after they’re referred to the C.O.R.E. clinic from the hospital or an outpatient clinic. We want to see them three to five days after hospitalization because readmissions often occur within seven days—typically because they’re overwhelmed or confused by their treatment plan and medications. After that initial visit, we follow up with them two weeks later. If they’re doing well, we’ll see them for a third visit in a month. We don’t have a strict protocol. Instead we take a personalized approach and see patients when they need more care.
Many patients come to the clinic and feel overwhelmed about taking new medicines, starting a new diet or weighing themselves every day—which are all necessary measures if you are diagnosed with congestive heart failure or cardiomyopathy. Over time, each patient begins to develop a relationship with the C.O.R.E. team and the team begins to better understand the patient’s needs. For example, we learn what each person likes to eat, we learn their daily habits and we learn how well they understand their condition. Because we have this relationship, we are better positioned to act like a safety net for patients.
A big part of our job is coordinating care with a patient’s primary care providers and other specialists—especially when patients have other conditions that affect their heart failure.
Through the clinic, patients become educated and learn how to help themselves. They learn who to call when they’re having shortness of breath or when they’re developing more symptoms. Instead of going to the emergency room, they can connect with a nurse or another appropriate resource. Emergency room staff can help them, but without ongoing education eventually they may return home and develop these symptoms again. We’re here to help stop that cycle.