Circulatory Health magazine

"This is the
healthcare of
the future”
Nurse practitioner:
for the best care as
well as service
“My colleagues and
I are the linking pin
in patient logistics"
Pieter Doevendans Linda van Tellingen & Esther de Haan Suzanne Elstgeest-Grootenboer
"We're here for the patients," says
Pieter Doevendans, Professor of
cardiology and responsible for
care within the strategic theme.
"In addition to providing the best
possible care, it's the experiences
of our patients that counts. They
must be seen by different
specialties and disciplines within
a few hours and have to feel
comfortable with that.
A pleasant patient experience and
improving the quality of care,
these are the main goals of the
cardiovascular outpatient clinic,
says Pieter. "We work with
different specialists, such as
internal medicine, vascular
surgery, neurology and cardiology.
It is essential that we use uniform
guidelines, which can differ
significantly for the individual
specialties. But with the outpatient
clinic that's a thing of the past,
which also benefits science.
Providing this much care within
such a short period of time hinges
on the logistics. Logistics must be
perfect, so that we can effectively
collect all data and draw up a
treatment proposal together. In
addition, patients must be
included more in science, for
instance so that their DNA can be
used for other genetic
cardiovascular research. The times
that a patient would go from
consulting room to consulting
room and specialists would
determine what happens, are over.
In the multidisciplinary outpatient
clinic, focus is on the patient: this
is the healthcare of the future.”
Even though patients in the
outpatient Center for Circulatory
Health see several healthcare
professionals, they always have a
nurse practitioner as permanent
contact. "We know everything
about every individual patient,"
says Linda van Tellingen.
"They come to us first with their
questions about care and
treatment."
"We conduct the necessary
preliminary work before a patient
visits the specialist," explains Linda.
"I update the medical history." Has
the patient been hospitalized
before, and for what? I review lab
results and identify risk factors. Is
the patient overweight, do they
have a high blood pressure, do
they smoke? To sum up, we focus
on risk management. Because all
patients who enter these doors
have one thing in common: they
are either already suffering from or
run a high risk of cardiovascular
disease. In addition to curative
treatment, we also pay a lot of
attention to prevention."
Nurse practitioners also monitor
cross-disciplinary cooperation.
Linda: "When I notice during triage
that we need a cardiologist in
addition to the vascular surgeon,
I see to it that the cardiologist is
available the same morning. It's
key that patients here receive the
best care as well as service."
From aneurysms and heart failure
to vascular claudication: the
outpatient Center for Circulatory
Health sees different patient
groups for a combination of
specialties. The team of medical
assistants ensures that patient
logistics run like a well-oiled
machine. "Patients must be able
to have all necessary
examinations and interviews
within half a day, like an express
train," says medical assistant
Suzanne Elstgeest-Grootenbroer.
"The process starts with
registration of the patient by the
family doctor," Suzanne explains.
"Or by a specialist in our or an
external hospital.
The referral is assessed by the
attending physician. They
determine which examinations and
appointments with other
specialties are necessary. My
colleagues and I are the linking pin
in the process of a patient's visit to
the clinic. Teamwork is vital for
this. We receive the patient and
answer any questions they may
have. But we also measure blood
pressure, if necessary, and the
pressure in the ankle and arm, the
so-called ankle-brachial index, in
preparation for the consultation
with the doctor. We also arrange
everything concerning wound
care, from A to Z. And after the
consultation, we conclude the visit
to the clinic and schedule a
follow-up appointment. All in all,
the medical assistants are involved
in the entire outpatient process.”
Circulatory Health Magazine 41