Every year the Triangle Business Journal recognizes individuals in our area who are true healthcare heroes.
While the Journal includes a nice profile and picture of the award winners (available online only to subscribers), we thought you might want to see their actual nominations and read first-hand what makes these individuals so special.
Our first highlighted winner is Marian Uy. Marian is a long-time employee who has touched the hearts and minds countless cardiac patients and their families during her tenure at WakeMed. Her profile truly shows that Marian has one of the biggest hearts in the business.
Marian Uy’s Healthcare Heroes Nomination
Manager, Heart Failure and Structural Heart Programs
WakeMed Health & Hospitals
TBJ Healthcare Heroes Award Winner – Category: Medical Professional
It was the late 1990s and Marian Uy had been a staff nurse in the Cardiac Care Unit (CCU) at WakeMed for 15 years. She loved her work, especially working with patients recovering from the trauma of heart failure. But one thing had long puzzled her: Why do we see so many patients back in the CCU so soon after they’re discharged?
On average, figures nationwide show that about 1 in 4 cardiac patients – primarily those suffering congestive heart failure – are readmitted to the hospital within 30 days of initial treatment.
It also bothered Marian that once a patient checked out, she had no idea how they were doing. Except, of course, the 25% who returned within 30 days. “Follow-up care was an unexplored area at the time.”
“My boss in the CCU at the time, Betsy Gaskins-McClaine, was very open to new ideas and innovation,” says Uy, who started working at WakeMed in 1984. “So I went to her and asked if we could study the problem and come up with a solution.
Turned out Gaskins-McClaine had similar concerns. Together, she and Uy conducted a study and their solution — the Congestive Heart Failure Program — was launched in 1999. Its goal: to not only do a more thorough job of educating heart patients about how to manage their condition while in the hospital, but to follow-up once they were released to make sure their recovery continued.
“Studies show that patients take in about 15% of the information they are given while they are in the hospital,” says Uy. “On our first follow-up call, which we do within 48 hours of discharge, we go over everything again.”
Previously, the education process consisted of a quick visit from a doctor just before discharge. “Basically, they were told what meds to take and to eat better.” Then they were on their own.
Under the Congestive Heart Failure (CHF) Program, patients have an extended visit with one of 5 nurses now in the CHF Program prior to discharge. Patients are also given a 24-page booklet that Uy was instrumental in creating, which explains the various types of heart failure and how the patient can manage – and recover from – their affliction.
After that initial 48-hour follow-up call, patients are contacted once a week for 6 weeks.
“We ask about their weight,” says Uy. “If they’ve gone up more than 2 pounds, that’s a sign that they’re retaining water – a red flag. We ask about their diet, their activity level. And we listen to hear if they’re short of breath, or if they pause between words and sentences. More red flags.”
After 6 weeks, patients are called every other week for 3 months. “And we tell them that if they have any problems to call us immediately.”
Since its inception in 1999, more than 4,000 patients have benefited from WakeMed’s CHF Program. About 1,300 CHF patients are currently active. “We make between 100 and 150 calls a day.” And the patients are listening.
Uy says for the latest reporting period, the percentage of CHF patients returning within 30 days was 14%. “And we’ve been as low as 10%,” she says.
A native of the Philippines, Marian earned her nursing degree from Velez College of Nursing in Cebu City. She loved the coursework, but she discovered that the rewards of nursing in her home country were limited. “The doctor made the decisions about patient care, and the nurse followed those instructions.”
Shortly after graduating, a recruiter visited her hospital in 1979 looking for candidates to ease a nursing shortage in the U.S. “We thought we were going to New York or Chicago,” Uy says with a laugh. She wound up in West Virginia.
But within the walls of Wyoming General Hospital in tiny Mullens, W. Va, the doctors would turn to Marian and say, “What do you think?” And Marian has been thinking and sharing her medical opinion ever since.
Her analytic and critical thinking skills were not only instrumental in the creation of WakeMed’s Congestive Heart Failure Program, they’ve also helped fuel the hospital’s Transcatheter Aortic Valve Replacement (TAVR) program – an option for patients who can’t undergo heart surgery – which launched in 2013.
She’s also the program coordinator for the American College of Cardiology’s Patient Navigator Program, which has adopted the CHF Program concept for patients suffering from heart attacks and heart failure.
Uy has dedicated the past 30 years to matters of the heart, an organ she became intrigued by in college.
“The heart is the organ of love, the organ of emotion, the organ of life. To me, the heart is life. That has always captivated me.”