New models for heart failure care delivery.

Area of Science:

• Cardiology
• Healthcare Management
• Implementation Science

Background:

• Heart failure (HF) is a global health concern with rising prevalence.
• Poorly controlled HF leads to high morbidity, mortality, rehospitalization, and healthcare costs.
• Despite proven guideline-directed medical therapies (GDMT), clinical inertia hinders optimal HF management, with few patients receiving all four GDMT classes.

Purpose of the Study:

• To highlight the critical need for HF implementation strategies.
• To bridge the gap between HF patients and essential GDMT.
• To explore various modalities for improving HF management.

Main Methods:

• HF implementation strategies are categorized by care setting: inpatient, discharge, and outpatient.
• Inpatient strategies include rapid GDMT titration, audit-and-feedback, virtual teams, and EHR alerts.
• Discharge strategies involve patient/provider education, summaries, and transitional programs.
• Outpatient strategies encompass digital tools, population management, team restructuring, remote monitoring, and hospital-at-home models.

Main Results:

• Various innovative strategies exist for HF implementation across different care stages.
• These strategies aim to improve GDMT optimization and overall HF care.
• The study underscores the need for novel implementation and monitoring methods due to the growing HF population.

Conclusions:

• Effective HF implementation is vital to address the gap in GDMT optimization.
• A multi-faceted approach addressing inpatient, discharge, and outpatient settings is necessary.
• Continuous innovation in HF implementation and monitoring is required to manage the increasing burden of heart failure.