Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Nov. 30, 2012 | Archived Issues

The house call gets an electronic update

With the help of a few home visits from nurse practitioner Florita Valenzuela, along with the support of his wife and son, Walter Blue has been able to recover at home after his serious health issues.

With a new twist to a tried-and-true process, Cedars-Sinai Medical Group has brought back the house call to provide an in-person and virtual care team visit to the homes of patients with complex, high-risk health issues. Patients like Walter Blue, who, in his own words, has "had a tough time of it" since his first surgery last March, although he certainly has maintained a good attitude and sense of humor.

Nurse practitioner Florita Valenzuela (top) and James Caplan, MD, (bottom) work as a team, in person and online, to support Walter Blue's recovery.

Blue's hospitalist, physicians, inpatient case managers and social workers identified him as a good candidate for house calls prior to his discharge from the hospital. In addition to his bypass surgery and kidney problems, he has high blood pressure, was very weak, had no appetite and lost 50 pounds. Until nurse practitioner Florita Valenzuela came into the picture, that is. "When I met Florita, I said, 'I've died and gone to heaven.' All of the post-Florita era has been uphill," he said with a smile.

Valenzuela worked with Blue and his family, helping them understand his problems and what he needed to do to manage his health, explaining what his son and wife could do to support his postsurgical recovery. She helped with appointment scheduling as well.

She electronically reported her health assessments back to Blue's primary care physician, James Caplan, MD, after each of her visits, so the information was accurate and timely for monitoring and treating his patient after surgery. In collaboration with Caplan, the ambulatory case manager and other members of the extended care team, she helped Blue get back his appetite and strength and incorporate exercise back into his life.

"Because I was taking so many medications, she arranged for me to talk with a pharmacist to make sure one medication wasn't counteracting another," Blue recalled. "There were duplications, so as a result, they reduced the number of high blood pressure pills I'm taking and I'm doing really well."

Valenzuela gets close to her patients, but she knows when it's time to say goodbye. "They're letting me into their private world, their home. I appreciate that," she explained. "Every time I came to check on the Blues, Walter was doing better, until one visit we realized he didn't need me anymore. And that was a really good thing."

Although it was a very difficult time for the Blue family, and Walter is still not back 100 percent, he describes himself as a very lucky man. "Dr. Caplan, my quarterback, kept getting me to the right specialists, and they were terrific," he said. "I had great physicians, so much support from my wife and son, and Cedars-Sinai's care was just marvelous." It was a happy ending for everyone.