Healing a Mother's Heart | Cone Health Heart & Vascular's OctoCARE Model

Chandrea Taylor Bell was heartbroken when she learned of her postpartum cardiomyopathy diagnosis, a form of heart failure that results from pregnancy. Watch how the OctoCARE team helped erase the stigma she felt with the diagnosis and improve her condition.

Eight is Great

Cone Health’s eight-part OctoCARE model embraces the whole person. Through this program, an interdisciplinary team navigates a wide range of factors influencing patient outcomes and wellness. The group consists of care guides, certified medical assistants, exercise physiologists, nurses, pharmacists and social workers. Together, they find the root causes of patients’ health issues, providing a seamless continuum of care through disease management and prevention. By addressing social determinants of health (SDoH), they break down barriers, improve access to health care, and provide prevention and wellness programming.

Dee Talley, RN, MHA, executive director of Cone Health’s Heart & Vascular Center, created the OctoCARE concept. She credits the multidisciplinary team for making the program possible.

“Caring for the heart is not just about fixing the mechanics and rhythms of the heart,” says Talley. “Sometimes it’s about healing the soul of the heart. That’s where OctoCARE plays an essential role in providing patient care to the whole person. We help patients not only heal physically but also emotionally, socially and spiritually.”

Program coordinator Jackie Brennan, LCSW, CCSW-MCS, adds, “OctoCARE is a unique model that engages every staff member and empowers them to make a difference in the lives of our patients.”

By coordinating with other programs, OctoCARE is poised to improve the overall health of Cone Health’s patients and that of the community.

Cone Health Heart & Vascular's OctoCARE Model

The OctoCARE model’s comprehensive services include:

	Pharmacy/Medication Needs: Connect to patient assistance programs; access resources from heart failure fund; offer medication counseling and education
	Home Health Needs: Refer to community paramedicine program; order home health equipment; partner with Cone Health congregational nursing; provide referrals to community home health agencies
	Healthy Food and Nutrition: Provide nutritional assessments and education; make food pantry referrals; offer cooking classes
	Health and Wellness: Provide personalized physical activity programming; organize walking clubs; offer Providers Referral Exercise Program (PREP); refer to cardiac rehab
	Disability/Financial/Insurance: Provide referrals to the Medicare and Seniors’ Health Insurance Information Program (SHIIP); assist with Medicare/ Medicaid concerns; help with disability- related aid
	Housing: Help find temporary and permanent housing solutions; provide rental assistance; assist with home repairs
	Transportation: Support Access GSO (formerly SCAT) paratransit applications; connect patients to Cone Health transport program and community transit resources
	Mental Health and Substance Abuse: Offer depression screening; provide therapy referrals; create stress reduction programming; host support groups; conduct alcohol/SA assessments and referrals to rehab

Help patients overcome barriers in their health care journey. Make a donation to the Heart and Vascular Patient Care Fund at conehealthphilanthropy.org