The Duke Heart Failure Same-Day Access Clinic offers a convenient clinical option for patients with heart failure (HF) while helping avoid repeat hospitalizations.

Considered an innovation for patients with HF several years ago, urgent care or same-day HF clinics are now offered by multiple medical centers, says Stephen J. Greene, MD, one of two cardiologists serving the clinic. The staff include Greene and Paul B. Rosenberg, MD, both advanced heart failure specialists, and nurse practitioners Midge Bowers, DNP, NP, and Karol Harshaw-Ellis, DNP, NP.

“One of the main purposes of the clinic is to offer a safety net for patients who cannot be seen by a clinician within seven days following HF hospitalization,” Greene says. Outcome data consistently show that the week following hospital discharge for patients with HF presents significant risk for clinical deterioration and readmission, Greene adds.

HF guidelines recommend early post-discharge follow-up as an important dimension of care, but some patients are not able to get an appointment with their clinician on  short notice after discharge, Greene adds. “Our clinic aims to bridge this gap and make sure they are seen by a heart failure expert without delay,” Greene says.

In general, the clinic serves two primary patient populations, Greene says:

• Patients experiencing worsening symptoms of HF who are considering an urgent ED visit or hospital admission.
• Patients with a recent HF hospitalization who need an early post-discharge follow-up appointment.

A primary goal of the clinic is to treat patients with worsening signs and symptoms outside the hospital to prevent the need for admission. “These patients can make an urgent care appointment for evaluation and receive intravenous diuretics to relieve fluid buildup, which is a common need among patients with worsening HF,” Greene says.

The clinic also offers an opportunity to adjust oral medications as appropriate. “We recognize that patients with worsening HF or a recent HF hospitalization are exceptionally high risk,” Greene says. “We want to provide a resource for them to receive the timely care they need and to give them the best chance of staying well and remaining out of the hospital.”

To refer a patient, call 919-681-5816 or email heartcen@dm.duke.edu.