Skip to main content


Regional’s Heart Failure Clinic Reduces Readmissions

Aug 28, 2018 06:00AM ● By MED Magazine

By Alex Strauss

Heart failure is the most common and costliest reason for admission to the hospital for older Americans. And yet, more than three in four HF patients who end up in the emergency room get admitted to the hospital. Often, these are readmissions are for an ongoing condition.

But the Regional Health Heart and Vascular Institute has found a way to reduce both the number of patients whose symptoms drive them to seek care in the ED and the number of hospital readmissions. Through a combination of education, interventions such as IV diuretic therapy, and careful, continual monitoring, the Heart Failure Clinic provides both an alternative to the emergency room and peace of mind for HF patients and their doctors.

“If their heart function is less than 35 percent and no one is keeping a close eye on them, they may end up having to get a defibrillator down the road,” says Jessica Tvedt, CNP, AGACNP, BC, who oversees the clinic along with cardiologists Dr. K. John Heilman and Dr. Alexander Schabauer.

“If we utilize our telemonitoring system to follow their pulmonary artery pressures and we stay on top of their medications, we can often keep them home and feeling good and out of the hospital.”

HF readmission at Regional hover at or below the national average at 16 to 18 percent. Regional implemented CardioMEMS, an implantable, battery-free PA monitoring system, in 2016. Research suggests CardioMEMBERS reduces HF hospital admissions by 37 percent and Tvedt says Regional’s experience has mirrored that trend.

With emphasis solely on HF, the clinic is also intended to take some of the burden of managing these often-complex patients off of the patient’s other physicians.

“Most of these patients are really sick,” says Twedt. “They have COPS or diabetes or kidney disease. They take a lot of time and work. It is difficult and it takes a lot of manpower.”

Tvedt says the Heart Failure Clinic in spreading the word about their services so that potential candidates get referred. Candidacy is assessed based on a number of factors such as EKG results, systolic and diastolic dysfunction, history of hospital admissions for HF, etc.

“Once we get them into the clinic, we are able to get their buy-in very quickly,” says Tvedt. “Patients like that people are watching them very closely. Once i see them once in the clinic, I can manage a lot over the phone. In the long run, it will save them office visits, as well.”


An alternative to blood thinners for Rapid City patients with non-valvular atrial fibrillation