Heart failure is a growing burden, contributing to about 45% of cardiovascular deaths, and one clinical leader believes it’s time for a care model redesign.
Heart failure has a five-year survival rate of about 50%, comparable to many cancers, and about 7 million adults are diagnosed with it, Peter George, MD, chief medical officer of cardiovascular services at Des Moines, Iowa-based UnityPoint Health, said in an upcoming episode of Becker’s “Cardiology + Heart Surgery Podcast.” Heart failure is also a dominant driver of costs and hospitalizations and is the top source of potentially avoidable admissions for older adults.
“There are really complex and fragmented care needs that go along with heart failure treatment — ongoing optimization of medical therapy, monitoring patients for decompensation, lifestyle management, and often devices and advanced therapies applied for treatment,” Dr. George said. “Implementation gaps are wide in heart failure, outcomes can vary greatly, and care is often reactive rather than proactive, which makes it a very challenging disease to treat.”
UnityPoint Health began redesigning their heart failure care model in 2022. Some of their most impactful changes include incorporating AI-drive care management protocols, patient education resources and support groups, utilizing telehealth and home-based care, implementing standardized systemwide protocols for stronger guideline-directed medical therapy optimization and creating tiered pathways by heart failure type.
For hospitals looking to improve their heart failure care models, Dr. George recommends a single high-impact step that can be launched quickly without hiring additional staff or new tech: standardized discharge protocols.
“This would include medication reconciliation with a focus on guideline-directed medical therapy, patient and family education using teach-back sessions — where you explain what patients should watch for, like symptoms of decompensation, daily weights, heart rate, blood pressure measurements and low-sodium diets, and then have them repeat it back to confirm understanding,” he said. “It should also include scheduling an in-person, follow-up appointment before the patient leaves the hospital, targeting a visit four to seven days post-discharge, along with a phone check-in within 24 to 72 hours after discharge.”
Listen to the full episode, along with others, here.
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