Heart failure affects 6 million people in the U.S., and although they represent just
over 2 percent of the total population, heart failure is the number one cause for
hospitalization for people over 65. While treatments are helping people live longer, the overall prevalence of heart failure has increased along with the incidence of hospital readmissions and mortality.
Since 2014, the Cardiovascular Clinical Program team has focused their efforts on reducing the incidence of heart failure and improving outcomes for high risk patients,
including reducing hospital readmissions and mortality, through the Heart Failure
Pathway for High Risk Patients. McKay-Dee Hospital piloted the pathway in 2014, and their
weekly collaboration and feedback helped shape and ready the program for enterprise-wide
implementation. Five Intermountain hospitals began using the pathway in 2015, the remaining 17 in 2016.
The Heart Failure Pathway is the structure around a comprehensive set of
processes and decisions, developed by our clinicians, to treat patients at risk
for heart failure. Here’s how it works: Multidisciplinary teams of doctors,
case managers, nurses, dietitians, and pharmacists review a home-grown and
validated daily report to accurately identify patients who are at high risk for
heart failure, hospital readmission, and mortality. This information helps
the teams intervene in a timelier manner and leads to improved outcomes.
The teams then deploy a set of best-practice processes and decisions to treat
patients according to their specific needs in the continuum of care.
One overarching body guides the work and measures the progress of
the Heart Failure Pathway, but the bulk of the work is accomplished
by the teams actually rendering the care using the tools and resources
developed by the Clinical Program. And because the work is coordinated
throughout all of Intermountain, our patients at high risk for heart
failure receive the same high standard of care at every Intermountain
hospital. “We’re successful because of our interdisciplinary approach,”
said Colleen Roberts, the program’s Operations Director. “Everyone is at
the table and involved from the beginning.”
McKay-Dee Pilot Program
In 2014 when McKay-Dee Hospital piloted the pathway,
mortality rates for patients participating in the pilot were 7% compared to 19% for patients not participating.
The percent of patients who were able to return home after hospital discharge
and continue care with homecare services as opposed to going to a skilled nursing facility
was 34% for those in the pilot compared to 19% for those not in the pilot.
Expanding Our Resources
Our Cardiovascular Clinical
Program is working hand-in-hand with the Primary Care Clinical
Program to identify risk factors like high blood pressure and lipid
levels, so the work begins before our patients enter our hospitals and
doesn’t end when they leave our hospitals. In the near future, we’ll be
expanding the resources available for our patients by connecting them
to community support groups where they will be able to speak with and
learn from others who are living with the same diagnosis and dealing
with the same challenges.
Stages of Heart Failure