The Patient Experience

heart-glovesThis page of our website provides a simple yet informative step-by-step guide to what you as the patient and your support system of family can expect when you trust your care and treatment to the Asheville Heart team.

For the sake of consistency, throughout this section, we refer to your “family” even though it may be a single individual or an extended group of family and friends. We should also point out that this information is based on the typical patient experience, but your particular situation may vary. You should always follow the directions of the hospital staff and members of the Asheville Heart team, even if they vary from what’s written here.

Please remember that as a patient, your comfort and peace of mind ate of utmost important to us. If you have any questions, concerns or comments, or just want to talk to someone about your experience as an Asheville Heart patient, please feel free to contact us at (828) 258-1121 during office hours.

Initial Consultation

Your first face-to-face experience with the Asheville Heart team will probably be for an initial consultation.

You may have been referred by a cardiologist or other physician, or you may have decided to consult one of our world-class surgeons for a second opinion. You may be one of the increasingly-frequent patients who has checked out the SCS database and been impressed by Asheville Heart’s high outcomes scores for your particular procedure, or you may have found us online and been intrigued by what we have to offer. Whatever the case, your treatment is very important to us and we want you to have the best possible experience.

You will be invited to call our Asheville office at (828) 258-1121 to make an appointment with one of our surgeons. Directions to our office can be found here.

Here are some important documents you will need:

  1. Any existing medical records, reports and test results provided by your referring physician (these may already have been sent ahead – please check with our office staff when you call for an appointment).
  2. A New Patient Form. You can click here to download the form and complete it before your visit. This will save some time at your appointment.
  3. A list of questions or concerns to discuss with the surgeon. If you check the clinical pages of this website, you will find detailed explanations of some common procedures and expected outcomes. Feel free to ask the surgeon for clarification if necessary.
  4. Your medical insurance card (if applicable) or form of payment.

During your initial consultation, the surgeon may ask about your symptoms, lifestyle, family history and any other information that he feels will help him to assess the best options for your care. He will discuss in detail the treatment options available to you and help you to make the most appropriate choices for your particular situation.

If (as we hope), you decided to trust your medical care to the Asheville Heart team, we will begin making arrangements for your surgical treatment, including arranging the date for your surgery. The day before the surgery, you will make your first visit to nearby Mission Hospital, where most of your clinical care will take place.

Registration at Mission Hospital

The day before your surgery, you will visit the hospital to register and receive important information. This will probably be your first visit to the Mission Hospital Cardiac Unit, so following these instructions will save you time and make things much smoother.

Before you set off to the hospital – please remember to get your insurance card and driver’s license or other photo ID. You’ll need these at check-in.

When you arrive at the hospital – turn off Biltmore Avenue into the Memorial Campus (you’ll actually be heading toward the ER). You will see the heart tower on the right as soon as you start up the hill. DO NOT GO TO THE HEART TOWER YET. Continue up the hill and take the second right turn which will take you to the Outpatient Registration department. Valet parking is available if required.

Go in the main entrance (seen in photo at right) of the administration building the registration area is through the first door on the left (restrooms are on the right). You will find the staff here friendly and helpful. They will need your insurance and photo ID so they can enter your details into the hospital system. This just takes a few minutes. They will then call the Cardiovascular (CV) staff at the Heart Center who will come to collect you.

A member of the CV staff will come to the registration waiting room and take you to room E445 in the Heart Center, which is the CV Admissions Area. Here you will get chest x-rays, lab work and in particular, you and your family will receive some very important instructions to help speed up your recovery. You will learn correct breathing techniques, the importance of walking after surgery, vital information about infection control, and other educational materials.

It’s a good idea for a member of the patient’s family to bring a pad and paper to make notes. You will hear a lot of good information and taking notes will ensure you remember as much of it as possible. If you are the patient, do not rely on hearing/understanding everything yourself. You will have a lot on your mind. Get a family member to help – they’ll appreciate the opportunity to be involved!

After leaving the CV Admissions Area (which is on the 4th floor), you’ll travel in the E “Evergreen” elevators to the ground floor of the Heart Tower. This is where you and your family will arrive on the day of surgery. If you parked in the main visitor parking lot or used Valet Parking, you might want to wait here in the waiting room while someone retrieves the car. They can leave by the front entranced of the Heart Center, turn right and walk down the hill, then right again. The sidewalk will take them back to the Outpatient Registration area where you came in and they can drive back to the Heart Center to collect you.

If it’s still early in the day and you’re a visitor to Asheville, turn right out of the Mission Hospital campus onto Biltmore Avenue and drive down the hill into historic Biltmore Village. Here you’ll find some wonderfully unique shops and restaurants to help you relax and enjoy the rest of your day.

Owen Heart Center

When you select the Asheville Heart team of world-class cardiothoracic surgeons to perform your surgical procedure, you can be safe in the knowledge that they have unique access to the award-winning facilities of the Owen Heart Tower at Mission Hospital in Asheville, North Carolina.

This state-of-the-art facility is ranked by Solucient as the only Top 100 Heart Hospital in the Carolinas, and is one of only four facilities in the state to win the Beacon Award for Critical Care Excellence in 2007/2008. The 5-story center contains:

  • 60 private rooms for heart patients
  • 16-bed cardiac intensive care unit
  • 6 cardiothoracic operating rooms
  • 40-bed cardiovascular progressive care unit
  • 20-bed cardiovascular intensive care unit
  • 70-seat amphitheater for physicians, staff and community education programs
  • Conference rooms for family use
  • Chapel with 24-hour chaplain service

 

The facility is located in the beautiful smoky mountains of western North Carolina, providing peaceful, relaxing and rejuvenating surroundings conducive to healing the body, mind and spirit.

To get to the Heart Tower, approach Mission Hospital via Biltmore Avenue. Heading south, the Heart Tower will be on the right immediately after passing under the MAHEC bridge (the second bridge you will pass under). Turn right into the Memorial Campus of Mission Hospital, then first right again. The 5-story Heart Tower is on the left and there’s a patient drop-off area in front of the main entrance.  For the closest parking, go past the patient entrance and follow the road around to the right to the top (outside) deck of the parking lot. If there are no available spaces, go back by the Heart Tower and turn right at the intersection. Follow the signs to the main hospital parking.

When you enter the Owen Heart Tower, there are waiting areas to the left and right and an information desk in the center. The main Cardiovascular (CV) area is on the fourth floor, which can be accessed by the “E” Evergreen elevators behind the information desk.

The Day of Surgery

On the day of your surgery it is not necessary to go the Outpatient Registration area.

Go straight to the Heart Center by turning off Biltmore Avenue into the Memorial campus as you did on your initial visit. However, this time take the immediate right turn and drive up the short hill to the main patient entrance of the Heart Tower. It’s a good idea to drop off the patient at the main entrance then continue up the hill. The road curves to the right and into the main parking for the Heart Center. If there are no spaces here, it may be necessary to go back to the main parking area.

Enter the Owen Heart Tower by the main entrance and you’ll be in the family waiting area with the Information Desk right in front of you. The supervisor or one of his/her staff will gladly direct you or your family to whatever facilities they need. Family members should wait here. The patient and no more than one family member should take the E “Evergreen” elevators behind the Information Desk and go up to the FOURTH floor.

The Cardiovascular (CV) Admissions Area is room E445 (this is where you were taken on your initial visit) and is directly ahead of you when you step off the elevator.

After checking in and going through various pre-operative procedures (depending on the type of surgery), you will be taken to the second floor, either to the Pre-op Holding Room <photo>, or directly to one of the six cardiothoracic operating rooms. You will almost certainly feel nervous and apprehensive. Try your best to relax, knowing you’re in the hands of one of the best cardiovascular teams in the world, operating in an award-winning, state-of-the-art facility.

Pre-Op Procedures

In one of the Pre-Op holding rooms on the second floor of the Owen Heart Center, you will be given medications to relax you during pre-operative preparation. You may feel groggy or “out of it” but you’ll be awake and aware of your surroundings.

As soon as the surgeon and his team are ready, your bed will be moved from the Pre-Op holding room to one of the six Cardiovascular (CV) operating rooms. These are also on the second floor of the Owen Heart Center.

There are family consultation/waiting rooms on this floor, which is where your family members will be invited to wait while your surgical procedure is in progress. In fact, the waiting rooms are just a few feet from the Operating Room (OR) on the other side of a dividing wall, so your family and friends will literally be very close to you during the entire procedure!

The Operating Room

One of the first things you’ll notice as you enter the OR is that there is a full team of people to take care of you.

These may include nurses and support staff, a perfusionist, an autotransfusionist, the anesthetist, one or more certified physician assistants (PA’s) and of course the surgeon, who is the head of the team and the one who will lead the entire procedure. There will also be a lot of equipment that is vital to the success of any operation.

It may seem that there is a lot of activity and you may feel overwhelmed but there are some important things you should know at this point:

  1. The surgeon and his team have already discussed your specific case in detail that morning. The discussion will have involved other surgeons, not just the one who will operate on you. They will have addressed any potential issues and opportunities to get the best possible surgical outcome.
  2. They have a specific plan for your care and treatment. The surgeon will have spent some time immediately before coming into the OR reviewing your case notes and preparing for your surgery.
  3. Every member of the team knows your name (the Asheville Heart surgeons insist on this as a matter of protocol; their patients are NEVER referred to by patient numbers).
  4. You may be one of several patients in the OR suite at the time (remember, there are six OR’s in the Owen Heart Center), but your surgical team is fully dedicated to your case during the entire time you are in their care.
  5. Your family and friends in the waiting room are considered a vital part of your recovery support system. They will be kept informed of your progress and any important milestones in your surgical procedure. After his work is done, the surgeon will personally provide a progress update to them and answer any general questions they may have that do not compromise your right to medical privacy.
  6. Your surgical procedure is the key to a successful outcome, but your care from the Asheville Heart team will continue long after the surgery is completed.

At the appropriate time, the anesthetist will place a mask over your nose and mouth, and as you gently fall asleep, all the knowledge, skills and experience of a world-class surgical team will now be focused on you!

Post-Surgery

After a successful operation, you will be transferred to either the Cardiovascular Intensive Care Unit (CVICU) or the Cardiovascular Recover Unit (CVRU), depending on your clinical requirements and they type of care the surgeon feels you will need. Both these units are on the third floor of the Owen Heart Center and the time spent here is dependent on the how quickly you recover from surgery, from just a few hours to several days.

Your first awareness of your new surroundings will probably not be very clear. You will still be under the latent effects of the surgical anesthesia, along with pain drugs and other medications.

CVICU are rooms E379 through E388 (Tel: 828-213-7390) and your family may be able to visit you in CICU, but because your care is being intensively monitored, their visits must be authorized by the nurse in charge. There are no “regular” visiting hours in CICU.

CVRU are rooms E368 through E378 (Tel: 828-213-7320) and a small number of family members will be allowed to visit you a few hours after your procedure.

The next step in the recovery process takes place in the Cardiovascular Progressive Care Unit on the fourth floor.

Cardiovascular Progressive Care

After the CRU, the next step in the recover process involves being transferred to the Cardiovascular Progressive Care Unit or CPCU. During this second phase of recovery, specially trained critical care nurses with post-surgical and cardiovascular expertise continue to care for and monitor patients.

Close attention and observation remain critical during this phase of recovery. Cardiac rehabilitation staff assists patients to progress to a low level of activity and provide education aimed at helping patients resume activities of daily living. Any lifestyle modifications that will be needed to ensure successful recovery will usually be identified here.

Hospital Discharge

Naturally, the main question on the mind of most patients is “When can I go home.”

Your progress in the CVPC unit will be monitored carefully and when the surgeon is satisfied that the healing process is proceeding appropriately, you will be provided with written discharge instructions.  These instructions will explain about pain control, bathing, cleaning the incision wound, exercising, and other important aspects of your ongoing care. You will also be advised about follow-up visits with the surgeon.

After the discharge paperwork is completed and you are dressed and ready to leave, a member of the nursing staff will take you from the Owen Heart Tower building in a wheelchair. If you are going home by car, the driver should collect you at the front entrance to the heart tower building. There is a circular driveway to make access easy, and the exit in under cover in case of bad weather.

The most important things to know are that as with any recovery process, there will be good days and bad, but it is vitally important to follow the instructions provided to you during the discharge process to ensure the best possible long-term results from your cardiovascular procedure.

Office Follow-Up

After going home from hospital, there may be several aspects to your ongoing care, but one of the most important is the need for follow-up visits with the surgeon who performed your procedure. These visits take place at the Asheville Heart offices (where you probably had your initial consultation) and will involve physical checks of the wound, blood pressure and other tests, and discussions with the surgeon about your rate of progress.

You should take advantage of this time to ask questions about the recovery process, medications, lifestyle changes, or any other issues that may be of concern.

Remember, the entire Asheville Heart team is committed to the best possible surgical outcome for every single patient.