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The Community Heart Failure Program: A Trauma-Informed Heart Failure Management Strategy
Megan M Streur1, Raelynn Cameron, Mrinal Yadava
1Author Affiliations : Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington (Dr Streur, Ms Cameron); Harborview Medical Center, Department of Medicine, University of Washington, Seattle, Washington (Dr Yadava); Harborview Medical Center, Seattle, Washington (Dr Pechan, Ms Smith); and Oregon Health and Science University, School of Nursing, Portland, Oregon (Dr Auld).
Background:
Individuals with heart failure (HF) and adverse social determinants of health (SDOH) experience significant health care disparities.
Local Problem:
We noted high rates of acute care utilization by patients with adverse SDOH and unmet social needs.
Methods:
This pilot quality improvement project used a pre-post design.
Intervention:
A nurse-led, trauma-informed, community-based HF program (CHFP) was developed, providing care at each patient's chosen location (eg, shelter, tent). Guideline-directed medical therapy was adjusted to achieve patient goals.
Results:
Sixteen patients participated in the CHFP. Reductions were seen in the number of emergency department visits, mean number of hospitalizations, and days hospitalized. The number of patients with ≥1 hospitalization significantly decreased from 12 to 5 ( P = .07). Cardiology outpatient encounters significantly increased from 11.19 to 19.38 ( P = .02).
Conclusions:
CHFP reduced acute care utilization and has the potential to improve patient outcomes.
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