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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).
A community-based heart failure program (CHFP) reduced acute care use in patients with adverse social determinants of health (SDOH). This innovative approach shows promise for improving outcomes for vulnerable populations.
Area of Science:
- Cardiology
- Health Services Research
- Public Health
Background:
- Individuals with heart failure (HF) and adverse social determinants of health (SDOH) face significant healthcare disparities.
- High rates of acute care utilization are observed in HF patients with unmet social needs.
Purpose of the Study:
- To evaluate the impact of a community-based heart failure program (CHFP) on acute care utilization among patients with adverse SDOH.
Main Methods:
- A pilot quality improvement project employed a pre-post design.
- A nurse-led, trauma-informed, community-based heart failure program (CHFP) was implemented, delivering care at patient-preferred locations.
- Guideline-directed medical therapy was individualized to meet patient goals.
Main Results:
- Sixteen patients participated in the CHFP.
- A reduction in emergency department visits, hospitalizations, and days hospitalized was observed.
- The number of patients with ≥1 hospitalization decreased significantly (12 to 5, P=.07), while cardiology outpatient encounters increased (11.19 to 19.38, P=.02).
Conclusions:
- The community-based heart failure program (CHFP) effectively reduced acute care utilization.
- CHFP demonstrates potential for improving health outcomes in heart failure patients facing social challenges.
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