Our program helps heart failure patients after they’ve been discharged from the hospital. We provide follow-up care for the first month after discharge to guide you through recovery, medication and lifestyle changes.
These appointments also allow us to track your health and adjust treatments if needed. Our goal is to keep you out of the hospital and as healthy as possible.
If your doctor refers you to our program, our heart failure nurse practitioner will meet with you once a week for four weeks. Our board certified pharmacist will join the first meeting to go over your medications.
Your appointments can be in person at Roper Hospital or through telehealth. Starting in early 2021, we’ll also offer appointments at Roper St. Francis Berkeley Hospital.
During your meetings, we’ll discuss:
- Diabetes education and prevention
- Dietary changes, including tips for a low-sodium diet
- Lifestyle modifications, such as exercise or smoking cessation
- Optimize your medication to help improve heart function and reduce side effects
- Resources to help with financial barriers, transportation and addiction, if needed
Our program also provides referrals to other services that can help with your recovery, such as:
Support services
We understand that some heart failure patients may face challenges with treatment. With that in mind, our team focuses on helping you overcome any barriers to your recovery. We can provide information and referrals for resources that help with:
- Anxiety and depression
- Drug and alcohol addiction
- Homelessness
- Finding a primary care doctor
- Paying for medication
- Transportation to and from the hospital or clinic
Home health monitoring
Our team works closely with Roper St. Francis Healthcare home health services and regional home health agencies to monitor heart failure patients at home when needed. This program tracks your vital signs, including blood pressure and weight. A nurse reviews these vital signs every morning and will contact our program with any significant changes.
If we’re concerned about any of your vitals, we can follow-up with you quickly — same-day appointments are available Monday-Friday. We can work with our pharmacist to adjust medications or schedule an appointment if needed. We also offer same-day IV diuretics if you have rapid weight gain from fluid buildup, which can help keep you out of the emergency room.