Implementing the Certified Heart Failure Educator System in Japan　- Initial Experience

The Japanese Circulation Society (JCS) launched a Certified Heart Failure Educator (CHFE) program in 2021. However, reports regarding this program are lacking. Here we describe the initial experience following implementation of CHFE program and assess its association with hospital quality measures.

We performed a retrospective study using data from CHFE certification data for 2021-2024 and data from the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination in 2021. The cumulative number of CHFEs increased from 1,771 in 2021 to 6,603 in 2024. Various medical professionals joined the system, and almost all CHFEs were affiliated with hospitals. Of all 813 hospitals included, 416 (51.2%) had at least 1 CHFE in 2021, with a median number of 2 CHFEs per hospital. The group of hospitals with CHFEs had a higher proportion of JCS training hospitals and a higher number of annual heart failure (HF) hospitalizations and cardiology beds. Of 71,678 patients hospitalized for acute HF and discharged to home, 41,558 (58.0%) were hospitalized in facilities with CHFEs. After adjustment for baseline characteristics, hospital admission to a facility with a CHFE was associated with higher achievement of process measures and lower in-hospital mortality.

The CHFE system was successfully implemented and contributed to HF management primarily in high-quality hospitals. Our findings may provide insights for future strategies regarding this system.