Face-to-face interactions with the patient’s physician
during the hospitalization and initial follow-up visit (aimed
at promoting continuity of care) helped to foster collaborative
relationships. APNs’ expertise in management of heart
failure and common comorbid conditions, coupled with
their ability to coordinate care, nurtured these relationships
and provided patients with increased access to symptom
management tools. For example, in collaboration with
physicians, APNs were able not only to teach patients and
caregivers about early symptom recognition, but also to
coach them regarding effective treatment, such as the use of
as-needed diuretics. Positioning patients and caregivers to
manage their symptoms was a goal for all intervention
group patients.